Testosterone Before Hypospadias Repair: Biology, Bias, and Practical Use

Preoperative testosterone is widely used before hypospadias repair, but the evidence remains controversial.This episode reframes androgen stimulation as measured medicine, not cosmetic enlargement. We discuss glans-width thresholds, penile length, urethral plate width, proximal hypospadias, androgen responsiveness, wound-healing concerns, fistula risk, and why response to testosterone may itself be clinically meaningful.The central idea: testosterone should not be used to make the operation feel easier. It should be used only when it changes anatomy that truly matters.Keywords: hypospadias, testosterone, androgen stimulation, glans width, proximal hypospadias, fistula, pediatric urology.