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      Efficacy and safety of percutaneous administration of dihydrotestosterone in children of different genetic backgrounds with micropenis

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          Abstract

          Background:

          Exogenous androgen supplement is an optional treatment for micropenis; however, its use in childhood is controversial due to potential side effects.

          Methods:

          Twenty-three children (mean age: 4.07±3.4 years) with micropenis of unknown causes harboring the 46,XY karyotype were recruited in an open prospective study. Androgen receptor (

          Results:

          Two patients were found with

          Conclusions:

          Short term and local application of DHT at low doses in patients with micropenis could accelerate penile growth effectively without evident side effects; however, precautions still need be taken due to the paucity of long term study and the lack of ideal DHT dosage.

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          Most cited references22

          • Record: found
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          Testosterone formation and metabolism during male sexual differentiation in the human embryo.

          E. Jane Costello, P Siiteri (1973)
          Article 0 comments Cited 53 times – based on 0 reviews     Review now
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            The increasing incidence of congenital penile anomalies in the United States.

            Caleb P Nelson, John Park, Julian Wan … (2005)
            Epidemiologic studies have suggested that the incidence of congenital penile anomalies (CPA), particularly hypospadias, is increasing. This phenomenon has significant biological and socioeconomic implications. We sought further confirmation of the reported trends using a large national database. The Nationwide Inpatient Sample is a 20% sample of United States hospitals containing data on 5 to 7 million hospital inpatient stays per year. We identified male newborns, used ICD-9 codes to identify newborns with CPA, determined nationally weighted incidence over time and performed multivariate analyses to identify factors associated with CPA. Of the 4.84 million male newborns in the Nationwide Inpatient Sample we identified 37,577 with CPA (weighted incidence rate 7.8/1000 newborns). The weighted incidence increased from 7.0/1000 newborns in 1988 to 1991 to 8.3/1000 in 1997 to 2000 (p <0.0001). The most common diagnosis was hypospadias (68.3%), followed by chordee (8.6%) and hypospadias plus chordee (5%). Unspecified genital or penile anomalies were reported for 14% of the cases. The highest incidence of CPA was in white newborns (9.2/1000), followed by black newborns (7.5/1000), Asians (5.0/1000) and Hispanics (4.7/1000) (p <0.0001). Socioeconomic status (SES) was strongly associated with CPA, with CPA odds 19% higher for the highest SES category versus the lowest (OR 1.18, 95% CI 1.16-1.20). Increasing incidence of CPA over time was observed even after adjusting for race/ethnicity, geographic region, insurance status and SES. These nationally representative, weighted analyses reveal a significant increase in the incidence of CPA, with striking variation by race, region and SES. Further research into potential causes, as well as the observed disparities in incidence, is needed.
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              Prostate-specific antigen changes and prostate cancer in hypogonadal men treated with testosterone replacement therapy.

              Jay Simhan, M Coward, Mary Farach-Carson (2009)
              To retrospectively review hypogonadal men receiving testosterone replacement therapy (TRT), and evaluate the changes in prostate-specific antigen (PSA) levels over an extended period, and thus evaluate the occurrence of prostate cancer, as a primary concern in treating late-onset hypogonadism (LOH) is the potential increased risk of prostate cancer; we also recorded the cardiovascular effects of TRT. In all, 81 hypogonadal men (mean age 56.8 years) were followed for a mean (range) of 33.8 (6-144) months after starting TRT. All men had a normal baseline PSA level before TRT and had routine laboratory investigations, including measurements of body mass index (BMI), haematocrit, lipid profile, and liver function tests (LFTs). Testosterone and PSA levels were assessed every 6-12 months. Patients with a biopsy-confirmed or recent history of prostatitis before treatment were excluded. TRT was discontinued in men who developed prostate cancer. Before and 36 months after treatment the total testosterone levels were 241.1 and 379.8 ng/dL (P or =70 years). In men with prostate cancer there was an increase in mean PSA level from baseline to 18 months of 1.8 ng/mL, and to 36 months of 3.2 ng/mL (P or =5 years, prostate cancer can be effectively diagnosed and treated in men taking TRT, and the incidence of prostate cancer among men with LOH on TRT is no greater than that in the general population.
              Article 0 comments Cited 21 times – based on 0 reviews     Review now
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                Author and article information

                Journal
                Title: Journal of Pediatric Endocrinology and Metabolism
                Publisher: Walter de Gruyter GmbH
                ISSN (Electronic): 2191-0251
                ISSN (Print): 0334-018X
                Publication date Created: November 27 2017
                Publication date (Print): November 27 2017
                Volume: 30
                Issue: 12
                Article
                DOI: 10.1515/jpem-2016-0400
                PubMed ID: 29176021
                SO-VID: 90f1110d-f4bd-40c9-9303-548f7a803194
                Copyright © © 2017
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