Abstract：
Local estrogen therapy has been explored as an alternative to conventional testosterone therapy in children requiring urethroplasty for hypospadias. Our objective is to evaluate if preoperative estrogen stimulation reduces post-urethroplasty complications and enhances penile dimensions. A systematic search was conducted on various databases, selecting only randomized controlled trials (RCTs) that tested estrogen on hypospadias patients under 18 years. Articles underwent sorting following PRISMA guidelines and bias risk was assessed using the JBI clinical appraisal tool for RCTs. Out of 607 screened records, 10 underwent full-text review, and 4 randomized controlled trials (RCTs) were selected for analysis. The total patient cohort across studies was 387 with 174 in the estrogen group. All studies utilized topical estrogen, but in different formulations and timings. Prudence is necessary for interpreting results due to variations in formulation, timing, and hypospadias type across studies. Limited by a small number of studies and outcome presentation non-uniformity, the review suggests no change in penile dimensions or postoperative complications with topical estrogen. Further research is needed to explore wound-healing properties of estrogen in hypospadias through animal and human studies.Registration and protocol: Registered in Prospero CRD42024502183.
摘要：
在需要尿道成形术治疗尿道下裂的儿童中，已经探索了局部雌激素治疗作为常规睾丸激素治疗的替代方法。我们的目标是评估术前雌激素刺激是否可以减少尿道成形术后并发症并增加阴茎尺寸。对各种数据库进行了系统的检索,仅选择对18岁以下尿道下裂患者进行雌激素检测的随机对照试验(RCTs).根据PRISMA指南对文章进行排序，并使用JBIRCT临床评估工具评估偏倚风险。在607条筛选记录中，10人进行了全文回顾，并选择4项随机对照试验(RCT)进行分析。研究中的患者队列总数为387，雌激素组为174。所有研究都使用局部雌激素，但是在不同的配方和时机。谨慎是必要的解释结果，由于配方的变化，定时,和尿道下裂类型的研究。受少数研究和结果呈现不一致的限制，该综述提示外用雌激素对阴茎尺寸或术后并发症无改变.需要进一步的研究通过动物和人体研究来探索雌激素在尿道下裂中的伤口愈合特性。注册和协议：在ProsperoCRD42024502183注册。
