Clinical Report: Comparative Network Meta-Analysis of Preoperative Hormonal Treatments

Overview

This study evaluates the efficacy of preoperative hormonal therapies in reducing postoperative complications in children undergoing hypospadias repair. Androgen therapy was found to significantly reduce the odds of urethrocutaneous fistula, while estrogen showed no significant benefits.

Background

Hypospadias is a common congenital anomaly affecting male genitalia, with surgical repair being the primary treatment. The success of this surgery can be influenced by various factors, including the use of preoperative hormonal therapy, which aims to improve surgical outcomes. Understanding the effectiveness of these therapies is crucial for optimizing surgical strategies and patient care.

Data Highlights

Key Findings

• Androgen therapy significantly reduced the odds of urethrocutaneous fistula (OR = 0.474; P = 0.031).
• The protective effect of androgen therapy for urethrocutaneous fistula was not statistically significant in distal hypospadias (OR = 0.613).
• No significant benefits of androgen therapy were observed for glans dehiscence or meatal stenosis.
• Estrogen therapy did not significantly reduce any postoperative complications.
• SUCRA analysis indicated androgen as the most probable effective intervention for fistula prevention.
• Further high-quality RCTs are needed, especially in distal hypospadias populations.

Clinical Implications

The findings indicate that preoperative androgen therapy may reduce the risk of urethrocutaneous fistula in pediatric patients undergoing hypospadias repair.

Conclusion

Preoperative androgen therapy may reduce the odds of postoperative urethrocutaneous fistula in children with hypospadias.

Related Resources & Content

1. Predictors of Surgical Complications in Distal Hypospadias Repair with Foreskin Reconstruction: An Anatomical and Intraoperative Analysis from a Prospective Study
2. Efficacy of transumbilical single-port and two-port laparoscopy in the treatment of pediatric inguinal hernia: a systematic review and meta-analysis
3. Evaluating the Impact of Mimicking Open Surgery Techniques on Outcomes in Pediatric Laparoscopic Hernia Repair: A Systematic Review
4. HYPOSPADIAS - European Association of Urology Guidelines
5. Effect of preoperative estrogen on complications after proximal hypospadias repair: A randomized controlled trial
6. Impact of Sex and Hormonal Factors on Surgical Outcomes Following Pituitary Procedures: A Systematic Review and Meta-Analysis
7. 2026 European Association of Urology/ESPU Paediatric Urology guideline chapter on hypospadias
8. Endocrine guideline for disorders/differences of sex development
9. Effect of preoperative estrogen on complications after proximal hypospadias repair: A randomized controlled trial - PubMed
10. https://wjmh.org/pdf/10.5534/wjmh.220173
11. Practice patterns in the care of proximal hypospadias among pediatric urologists - ScienceDirect