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

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 (AR), steroid 5α-reductase-2 (SRD5A2), and SRY genes were sequenced; 2.5% dihydrotestosterone (DHT) transdermal gel (0.1-0.3 mg/kg/day) was applied and titrated within the normal DHT serum reference ranges. Stretched penile length (SPL) was measured before therapy, and after 1, 3 and 6 months of DHT gel treatment, respectively.

RESULTS:

Two patients were found with AR gene mutations and five patients with SRD5A2 gene mutations. Average stretched penile lengths (SPLs) were 1.68±0.6 cm at baseline and 2.2±0.66 cm, 2.6±0.59 cm and 2.9±0.55 cm (mean ± 1 SD) after 1, 3 and 6 months of treatment, respectively. Fourteen cases (61%) reached standard penile length ranges (>-2.5 SD) and medication was discontinued; six cases (26%) were satisfied with the improved penile lengths despite failing to reach the aged matched standards. Three infants (13%) discontinued the medication after 3 months due to anxiety about the potential side effects. No significant side effects were found except the elevated DHT serum levels after therapy.

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.

• Authors: Dan Xu, Liangsheng Lu, Li Xi, Ruoqian Cheng, Zhou Pei, Yunli Bi, Shuangsui Ruan, Feihong Luo
• Journal: Journal of pediatric endocrinology & metabolism : JPEM (J Pediatr Endocrinol Metab) Vol. 30 Issue 12 Pg. 1285-1291 (Nov 27 2017) ISSN: 2191-0251 [Electronic] Germany
• PMID: 29176021 (Publication Type: Clinical Trial, Journal Article)

Chemical References

• AR protein, human
• Gels
• Membrane Proteins
• Receptors, Androgen
• SRY protein, human
• Sex-Determining Region Y Protein
• Dihydrotestosterone
• 3-Oxo-5-alpha-Steroid 4-Dehydrogenase
• SRD5A2 protein, human

Topics

• 3-Oxo-5-alpha-Steroid 4-Dehydrogenase (genetics)
• Administration, Cutaneous
• Child
• Child, Preschool
• DNA Mutational Analysis
• Dihydrotestosterone (administration & dosage, adverse effects)
• Gels
• Genetic Background
• Genital Diseases, Male (drug therapy, epidemiology, genetics)
• Humans
• Infant
• Male
• Membrane Proteins (genetics)
• Mutation
• Penis (abnormalities, drug effects, growth & development)
• Receptors, Androgen (genetics)
• Sex-Determining Region Y Protein (genetics)
• Treatment Outcome