Global InformationHypospadias information
| Hypospadias | |
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| Different types of hypospadias | |
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| Specialty | Urology, medical genetics |
Hypospadias is a common variation in fetal development of the penis in which the urethra does not open from its usual location on the head of the penis. It is the second-most common birth defect of the male reproductive system, affecting about one of every 250 males at birth,[3] although when including milder cases, is found in up to 4% of newborn males.[4] Roughly 90% of cases are the less serious distal hypospadias, in which the urethral opening (the meatus) is on or near the head of the penis (glans). The remainder have proximal hypospadias, in which the meatus is all the way back on the shaft of the penis, near or within the scrotum. Shiny tissue that typically forms the urethra instead extends from the meatus to the tip of the glans; this tissue is called the urethral plate.
In most cases, the foreskin is less developed and does not wrap completely around the penis, leaving the underside of the glans uncovered. Also, a downward bending of the penis, commonly referred to as chordee, may occur.[5] Chordee is found in 10% of distal hypospadias[3] and 50% of proximal hypospadias[6] cases at the time of surgery. Also, the scrotum may be higher than usual on either side of the penis (called penoscrotal transposition).
The cause of hypospadias is unknown; scientists have investigated both genetic and environmental mechanisms, such as prenatal hormones.[7][8] Another model suggests hypospadias arises as a result of unerased epigenetic markers which canalize sexual development.[4] It most often occurs by itself, without other variations, although in about 10% of cases it may be part of disorder of sex development condition or a medical syndrome with multiple abnormalities.[9][10]
The most common associated difference is an undescended testicle, which has been reported in around 3% of infants with distal hypospadias and 10% with proximal hypospadias.[11] The combination of hypospadias and an undescended testicle sometimes indicates a child has a difference of sex development condition, so additional testing may be recommended to make sure the child does not have congenital adrenal hyperplasia with salt wasting or a similar condition where immediate medical intervention is needed.[12][13] Otherwise no blood tests or X-rays are routinely needed in newborns with hypospadias.[3]
Hypospadias can be a symptom or indication of a difference in sex development,[14] but some consider that the presence of hypospadias alone is not enough to classify someone as a person with a difference/variation in sex development or as intersex. In most cases, hypospadias is not associated with any other condition.[15] Hypospadias is sometimes considered as an intersex condition by several intersex rights activist groups, who consider the repositioning of a working urethra on a child too young to consent to be a human rights violation.[16][17][18]
- ^ Entry "hypospadias" in Merriam-Webster Online Dictionary.
- ^ OED 2nd edition, 1989 as /hɪpəʊˈspeɪdɪəs/~/haɪpəʊˈspeɪdɪəs/
- ^ a b c Snodgrass W (2012). "Chapter 130: Hypospadias". In Wein A, Campbell MF, Walsh PC (eds.). Campbell-Walsh Urology, Tenth Edition. Elsevier. pp. 3503–3536. ISBN 978-1-4160-6911-9.
- ^ a b Cite error: The named reference
:1was invoked but never defined (see the help page). - ^ King S, Beasley S (2012) [1st. Pub. 1986]. "Chapter 9.1:Surgical Conditions in Older Children". In South M (ed.). Practical Paediatrics, Seventh Edition. Churchill Livingstone, Elsevier. pp. 266–267. ISBN 978-0-702-04292-8.
- ^ Snodgrass W, Prieto J (October 2009). "Straightening ventral curvature while preserving the urethral plate in proximal hypospadias repair". The Journal of Urology. 182 (4 Suppl): 1720–5. doi:10.1016/j.juro.2009.02.084. PMID 19692004.
- ^ "Hypospadias - Symptoms and causes". Mayo Clinic. Retrieved 2023-12-13.
- ^ Cite error: The named reference
:2was invoked but never defined (see the help page). - ^ Stoll C, Alembik Y, Roth MP, Dott B (September 1990). "Genetic and environmental factors in hypospadias". Journal of Medical Genetics. 27 (9): 559–63. doi:10.1136/jmg.27.9.559. PMC 1017217. PMID 2231648.
- ^ Calzolari E, Contiero MR, Roncarati E, Mattiuz PL, Volpato S (August 1986). "Aetiological factors in hypospadias". Journal of Medical Genetics. 23 (4): 333–7. doi:10.1136/jmg.23.4.333. PMC 1049700. PMID 3746833.
- ^ Wu H, Wei Z, M G (2002). "Hypospadias and enlarged prostatic utricle". Chinese Journal of Urology. 12: 51–3.
- ^ Kaefer M, Tobin MS, Hendren WH, Bauer SB, Peters CA, Atala A, et al. (April 1997). "Continent urinary diversion: the Children's Hospital experience". The Journal of Urology. 157 (4): 1394–9. doi:10.1016/S0022-5347(01)64998-X. PMID 9120962.
- ^ Tarman GJ, Kaplan GW, Lerman SL, McAleer IM, Losasso BE (January 2002). "Lower genitourinary injury and pelvic fractures in pediatric patients". Urology. 59 (1): 123–6, discussion 126. doi:10.1016/S0090-4295(01)01526-6. PMID 11796295.
- ^ "Explaining Disorders of Sex Development & Intersexuality".
- ^ Tidy, Colin (January 19, 2016). "Hypospadias". Patient. Patient Platform Ltd. Retrieved October 18, 2018.
- ^ "What is intersex? Frequently Asked Questions and Intersex Definitions". interACT. Retrieved May 7, 2021.
- ^ "Alice Dreger: Do you have to pee standing up to be a real man? – Intersex Human Rights Australia". ihra.org.au. 2014-02-14. Retrieved 2022-03-22.
- ^ "IGM". OII Europe. 2021-02-04. Retrieved 2022-03-22.