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Dr Dipesh Goel
Dr Gaurav Singal
Dr Sonam Agrawal
Dr Prateek Sharda


Microphallic hypospadias, Parenteral testosterone therapy


Background and objective: Microphallic hypospadias is challenge to surgical repair. There is
deficiency of the tissues. But, with parenteral use of testosterone there is increase in dimensions and
neovascularisation in all penile tissues. Surgery performed on augmented penile tissue has better
blood supply and outcome. This study focuses to estimate the size of microphallic hypospadias after
administration of parenteral testosterone in pre-operative period. To determine the adverse effects of
parenteral testosterone given to children pre operatively. To determine the complications in
intraoperative and postoperative period.
Methods: Penile dimensions are measured pre and post testosterone therapy in preoperative period.
Testosterone enanthate in a dose of 2mg/kg/dose deep intra muscular given at 0,3 and 6 weeks.
Adverse effects of testosterone therapy and complications of the surgery noted.
Results: There is increased mean penile length from penoscrotal junction (37.4%), transverse
preputial diameter (38.7%), glans width (76%), and width of the urethral plate (58%). Injection site
redness is the only adverse effect seen in 13.6% of children in preoperative period. Intraoperative
bleeding (18.1%), urethrocutaneous fistula (9%), postoperative haematoma (9%), wound infection
(4.5%) and wound dehiscence (4.5%) were the commonest side effect observed.
Conclusions: Use of testosterone is safe and effective in children with microphallic hypospadias. The
complications rate of surgery in microphallic hypospadias with preoperative testosterone parenteral
therapy is similar as with normal hypospadias without use of preoperative parenteral testosterone

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