Topical dihydrotestosterone to treat micropenis secondary to partial androgen insensitivity syndrome (PAIS) before, during, and after puberty - a case series

Journal of Pediatric Endocrinology & Metabolism : JPEM
David BeckerBenjamin J Wheeler

Abstract

X-linked partial androgen insensitivity syndrome (PAIS) causes under-virilization at all stages of development. In two thirds of males, this results in micropenis. Dihydrotestosterone (DHT) is a potent androgen that is critical for male genital development, which when applied topically, has been shown to increase penile length with micropenis of varying etiologies. We present the first case series using topical DHT gel to treat micropenis in 46,XY males with PAIS, before, during, and after puberty. Three related 46,XY males with confirmed p.L712F androgen receptor mutations exhibited varying degrees of micropenis post-surgical correction. They were of pre-pubertal, peri-pubertal and adult ages, respectively. Following baseline clinical and laboratory assessments all completed a 4-month course of daily DHT gel 2.5% (androstanolone) topically to penis (0.3 mg/kg body weight), with monitoring for adverse effects. Primary outcome was change in stretched penile length (SPL) following treatment. Mixed results were obtained following topical DHT therapy. In the pre- and peri- pubertal patients, SPL changed from 2.5 cm to 3.5 cm (+40%), and 3.5 cm to 5.7 cm (+63%), respectively. In the adult patient with 1 year of prior high-dose weekl...Continue Reading

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Citations

Aug 1, 2019·Endocrine Reviews·Amy B WisniewskiBerenice B Mendonca
May 26, 2020·American Journal of Men's Health·Rodolfo A Rey, Romina P Grinspon
May 17, 2018·Archives of Endocrinology and Metabolism·Rafael Loch BatistaBerenice Bilharinho de Mendonca
Aug 26, 2021·Curēus·Marcio José Concepción-ZavaletaFrederick Glenn Massucco Revoredo
Dec 19, 2019·Hormone Research in Pædiatrics·Marianna Rita StancampianoS Faisal Ahmed

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