{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T23:53:50Z","timestamp":1790898830571,"version":"4.1.0"},"reference-count":19,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2025,2,27]],"date-time":"2025-02-27T00:00:00Z","timestamp":1740614400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Children"],"abstract":"<jats:p>Objectives: The preoperative hormonal treatment (PHT) in eligible patients has the potential to become an asset for the treatment of severe hypospadias. The aim of the paper is to report the preliminary results on tolerability and efficacy of tailored transdermal PHT with testosterone before primary hypospadias repair, resulting by the joint activity between pediatric surgeons and endocrinologists. Methods: A retrospective study collected all the patients affected by severe hypospadias, with a glans width (GW) &lt; 14 mm and\/or a penile ventral curvature &gt; 30\u00b0, treated with preoperative transdermal testosterone gel 2% at a standard dose of 2 mg\/day after pediatric endocrinologist evaluation, from December 2020 to February 2024. Increases in GWs and penile lengths (PLs), together with adverse events and the rate of surgical complications, were reported. Results: During the period, ten patients were included and received transdermal PHT for 43 (\u00b115) days on average. The treatment with PHT stopped 52 (\u00b123) days before surgery. PL increased 0.76 (\u00b10.27) cm (+37%) on average, and GW increased 0.42 (\u00b10.26) cm (+40%). No adverse events were described. Three surgical complications were reported with an overall rate of 30%. Conclusions: Transdermal PHT was well-tolerated and showed a positive impact on the treatment of severe hypospadias. Future investigations might confirm these findings.<\/jats:p>","DOI":"10.3390\/children12030296","type":"journal-article","created":{"date-parts":[[2025,2,27]],"date-time":"2025-02-27T03:37:57Z","timestamp":1740627477000},"page":"296","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Preliminary Experience with Transdermal Preoperative Hormonal Treatment Before Severe Hypospadias Repair: Synergy Between Pediatric Surgeons and Endocrinologists"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0288-8990","authenticated-orcid":false,"given":"Laura","family":"Lucaccioni","sequence":"first","affiliation":[{"name":"Pediatric Unit, Department of Medical and Surgical Sciences of the Mother, Children and Adults, University of Modena and Reggio Emilia, 41125 Modena, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Filippo","family":"Ghidini","sequence":"additional","affiliation":[{"name":"Pediatric Surgery Unit, Department of Medical and Surgical Sciences of the Mother, Children and Adults, University of Modena and Reggio Emilia, 41125 Modena, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paolo","family":"Repetto","sequence":"additional","affiliation":[{"name":"Pediatric Surgery Unit, Department of Medical and Surgical Sciences of the Mother, Children and Adults, University of Modena and Reggio Emilia, 41125 Modena, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Grazia","family":"Spampinato","sequence":"additional","affiliation":[{"name":"Pediatric Surgery Unit, Department of Medical and Surgical Sciences of the Mother, Children and Adults, University of Modena and Reggio Emilia, 41125 Modena, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Insalaco","sequence":"additional","affiliation":[{"name":"Post-Graduate School of Pediatrics, University of Modena and Reggio Emilia, 41125 Modena, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"Vandelli","sequence":"additional","affiliation":[{"name":"Post-Graduate School of Pediatrics, University of Modena and Reggio Emilia, 41125 Modena, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Viola","family":"Trevisani","sequence":"additional","affiliation":[{"name":"Pediatric Unit, Department of Medical and Surgical Sciences of the Mother, Children and Adults, University of Modena and Reggio Emilia, 41125 Modena, Italy"},{"name":"PhD Program, Clinical and Experimental Medicine, University of Modena and Reggio Emilia, 41125 Modena, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0370-7872","authenticated-orcid":false,"given":"Lorenzo","family":"Iughetti","sequence":"additional","affiliation":[{"name":"Pediatric Unit, Department of Medical and Surgical Sciences of the Mother, Children and Adults, University of Modena and Reggio Emilia, 41125 Modena, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pier Luca","family":"Ceccarelli","sequence":"additional","affiliation":[{"name":"Pediatric Surgery Unit, Department of Medical and Surgical Sciences of the Mother, Children and Adults, University of Modena and Reggio Emilia, 41125 Modena, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,2,27]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1038\/nrurol.2011.24","article-title":"The influence of perioperative factors on primary severe hypospadias repair","volume":"8","author":"Castagnetti","year":"2011","journal-title":"Nat. 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Urol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1314","DOI":"10.1097\/JU.0000000000002481","article-title":"Quantifying Glans Width Changes in Response to Preoperative Androgen Stimulation in Patiens Undergoing Hypospadias Repair","volume":"207","author":"Mittal","year":"2022","journal-title":"J. Urol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"118","DOI":"10.1016\/j.jpurol.2013.07.006","article-title":"Objective use of testosterone reveals androgen insensitivity in patients with proximal hypospadias","volume":"10","author":"Snodgrass","year":"2014","journal-title":"J. Pediatr. Urol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"158","DOI":"10.1016\/j.jpurol.2010.05.003","article-title":"Does androgen stimulation prior to hypospadias surgery increase the rate of healing complications?\u2014A preliminary report","volume":"7","author":"Gorduza","year":"2011","journal-title":"J. Pediatr. Urol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"558","DOI":"10.5534\/wjmh.220173","article-title":"Effect of Preoperative Androgen Stimulation on Penile Size and Postoperative Complication Rate in Patients with Hypospadias: A Systematic Review and Meta-Analysis","volume":"41","author":"Do","year":"2023","journal-title":"World J. Mens. Health."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"250","DOI":"10.1016\/j.jpurol.2023.01.013","article-title":"Preoperative hormone therapy in single-stage repair of hypospadias: A comprehensive systematic review","volume":"19","author":"Di","year":"2023","journal-title":"J. Pediatr. Urol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"352","DOI":"10.1097\/JU.0000000000003548","article-title":"Does Preoperative Testosterone Administration Decrease Complications in Distal Hypospadias Repair With Urethroplasty?","volume":"210","author":"Godlewski","year":"2023","journal-title":"J. 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Metab."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1166","DOI":"10.1016\/j.urology.2015.01.035","article-title":"Meta-analysis of Androgen Insensitivity in Preoperative Hormone Therapy in Hypospadias","volume":"85","author":"Zhao","year":"2015","journal-title":"Urology"},{"key":"ref_15","first-page":"1","article-title":"Efficay of preoperative testosterone therapy in hypospadias: A systematic review and meta-analysis","volume":"17","author":"Semibiring","year":"2021","journal-title":"Ann. Pediatr. Surg."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"698.e1","DOI":"10.1016\/j.jpurol.2023.07.015","article-title":"Preoperative hormone stimulation; does it increase hypospadias postoperative complications?","volume":"19","author":"Fawzy","year":"2023","journal-title":"J. Pediatr. 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Urol."}],"container-title":["Children"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2227-9067\/12\/3\/296\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T16:43:08Z","timestamp":1760028188000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2227-9067\/12\/3\/296"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,2,27]]},"references-count":19,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2025,3]]}},"alternative-id":["children12030296"],"URL":"https:\/\/doi.org\/10.3390\/children12030296","relation":{},"ISSN":["2227-9067"],"issn-type":[{"value":"2227-9067","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,2,27]]}}}