The Role of Preoperative Androgen Stimulation in the Management of Hypospadias

The role of preoperative androgen stimulation (PAS) in hypospadias remains controversial. The published literature is of low quality and lacks standardized reporting of important patient and surgical details. Very few randomized controlled studies recommended the judicious use of PAS in distal hypospadias. The majority of surgeons tend to use PAS in proximal hypospadias with small glans and/or narrow urethral plate. Most studies agree the PAS increases the size of the penis but vary on its role in outcome. Side effects have been reported with significant heterogenicity. Further research is needed to determine whether PAS improves surgical outcome.