Estudo morfológico e histoquímico sobre o efeito tissular na pele do prepúcio à administração tópica de estradiol ou testosterona no pré-operatório de pacientes com hipospádia: ensaio clínico randomizado duplo-cego

Abstract

The use of preoperative topical testosterone stimulation prior to hypospadias correction aims to increase penile size and achieve better surgical results. Topical estradiol has been shown to improve the quality of skin in other sites, but its use in boys with hypospadia has not yet been elucidated. This study aims to evaluate the primary effects of topical hormone therapy in epidermal thickness and collagen distribution in skin of prepuce before hypospadia surgery. Patients were randomized into three groups according to the topical hormone used: TG: Testosterone ointment; EG: Estradiol ointment; CG: Neutral base ointment. Fragments of foreskin were excised, fixed and then sectioned for histology. For each sample, epidermal thickness and dermal collagen expression was measured by specific computer analysis, p-values of <0.05. Thirty-three patients with a mean age of 4.01 ± 2.92 years were included. Hypospadia classification was similar in all three groups. Mean epidermal thickness and collagen type I expression in EG were greater than those of the other groups. Collagen type III expression was similar in all groups. Use of topical estradiol before hypospadias surgery lead to greater epidermal thickness and increased dermal collagen expression in foreskin.