The effect of preoperative hormonal stimulation on the urethral plate; A histologic and histochemical study

• Published in: Journal of pediatric urology 2024-10, Vol.20 (5), p.859-864
• Main Authors: Sennert, Michael, Perske, Christina, Fawzy, Mohammed, Wirmer, Johannes, Hadidi, Ahmed T.
• Format: Article
• Language: English
• Subjects: Child, Preschool; Hormone therapy; Humans; Hypospadias; Hypospadias - pathology; Hypospadias - surgery; Infant; Male; Preoperative Care - methods; Preoperative hormone stimulation; Preoperative hormone therapy; Urethra - surgery; Urethral plate; Urologic Surgical Procedures, Male - methods
• ISSN: 1477-5131; 1873-4898; 1873-4898
• DOI: 10.1016/j.jpurol.2024.06.040

Preoperative hormone stimulation (PHS) is used to increase the glans size and may improve the cosmetic appearance after hypospadias surgery. The exact effect of PHS on different penile tissues remains unclear and controversial. Previous studies showed that PHS increased vessel density in the foreskin. However, the effect of PHS on the urethral has never been studied before. In this study we examine the PHS effects on the urethral plate. Specimens of the urethral plate and the underlying tissue were excised to correct severe chordee in 16 children with proximal and perineal hypospadias with severe chordee in 2 groups. Group A consisted of 8 children received PHS prior to surgery. Group B included 8 children with proximal and perineal hypospadias with severe chordee who did not receive PHS and served as a control group. Specimens were examined blindly using hematoxylin-eosin and elastic van-Gieson stain as well as factor 8 and SMA antibodies. The median age of Group A was 13 (range 10–20) months. The median age of Group B (without prior PHS) was 17 (range 14–29) months (p = 0,03). The median vessel-density in group A (82 vessels per mm2) was significantly higher than in Group B (65 per mm2), (p