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This review aims to summarise: (i) the penile tissue response to hormone therapy, (ii) its impact on hypospadias surgery outcomes, and (iii) the endocrinological considerations and sequelae. PHT is more often indicated for complex cases such as proximal hypospadias, hypospadias with microphallus and hypospadias reoperations. While PHT has clear effects on penile morphometry, and more recent controlled trials suggest improved surgical outcomes, the lack of consistent outcome definitions and generally inadequate follow\u2010up periods continue to consign many of the potential long\u2010term effects of PHT to the unknown. There is currently insufficient robust evidence to allow a clinical guideline to be constructed. The need for a well\u2010powered multi\u2010centre prospective randomised trial to address this question is evident but awaits a unified consensus on issues surrounding the understanding of aetiology, classification of hypospadias morphology, definition of important prognostic variables and uniform application of outcome measures. The effects of PHT may be utilised to improve outcomes in cases of proximal and severe hypospadias, which under the current paradigm represent a significant surgical challenge.<\/jats:p>","DOI":"10.1111\/jpc.16087","type":"journal-article","created":{"date-parts":[[2022,7,6]],"date-time":"2022-07-06T11:29:45Z","timestamp":1657106985000},"page":"1508-1519","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Defining the role of pre\u2010operative hormonal therapy in hypospadias"],"prefix":"10.1111","volume":"58","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1837-9966","authenticated-orcid":false,"given":"Kiarash","family":"Taghavi","sequence":"first","affiliation":[{"name":"Department of Paediatric Urology Monash Children's Hospital  Melbourne Victoria Australia"},{"name":"Department of Paediatric Urology Royal Children's Hospital  Melbourne Victoria Australia"},{"name":"Department of Paediatrics Monash University  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7310-9777","authenticated-orcid":false,"given":"Lomani A","family":"O'Hagan","sequence":"additional","affiliation":[{"name":"School of Medicine The University of Auckland  Auckland New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacqueline K","family":"Hewitt","sequence":"additional","affiliation":[{"name":"Department of Paediatrics Monash University  Melbourne Victoria Australia"},{"name":"Department of Paediatric Endocrinology and Diabetes Monash Children's Hospital  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pierre DE","family":"Mouriquand","sequence":"additional","affiliation":[{"name":"Service d'Urologie P\u00e9diatrique H\u00f4pital M\u00e8re\u2010Enfant, Hospices Civils de Lyon Universit\u00e9 Claude\u2010Bernard  59 Boulevard Pinel Bron France"},{"name":"Centre National de R\u00e9f\u00e9rence Maladies Rares sur les Anomalies Cong\u00e9nitales du D\u00e9veloppement G\u00e9nital  Lyon France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,7,6]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5347(17)61657-4"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpurol.2020.06.001"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.3906\/sag-1507-72"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpurol.2014.02.008"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpurol.2013.04.008"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2011.08.031"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpurol.2017.09.020"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1464-410X.2004.04706.x"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpurol.2017.06.019"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.beem.2015.03.002"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.3389\/fped.2015.00031"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5347(01)68102-3"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1159\/000441988"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.juro.2011.01.035"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5347(17)32694-0"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.juro.2007.09.098"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00383-008-2278-6"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5347(17)42014-3"},{"key":"e_1_2_7_20_1","first-page":"66","article-title":"A prospective study on the effects of topical testosterone in management of distal hypospadias","volume":"9","author":"Kumar P","year":"2020","journal-title":"Int. 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