http://www.fpnotebook.com/

Hypospadias

See Also
1. Genitourinary Examination in Infants
Epidemiology
1. Prevalence: 4.7 to 8 per male births
Predisposing factors: Family History
1. Father with Hypospadias: 8% risk
2. Brother with Hypospadias: 14% risk
Pathophysiology
1. Congenital defect of urethral meatus development
2. Urethral folds incompletely fuse
3. Ectopic urethral meatus between glans and perineum
Associated conditions
1. Undescended Testicle (10% association)
2. Inguinal Hernia
3. Hydrocele
4. Chordee (ventral penile curvature)
Classification
1. Anterior (Distal penis and glans): 50% of cases
2. Middle (Midshaft of penis): 30% of cases
3. Posterior (Scrotum, Perineum): 20% of cases
Management
1. Avoid Circumcision (foreskin needed for repair)
2. Surgical repair at 6 to 12 months of age
Complications of surgical repair
1. Complications 5-15% (highest for posterior Hypospadias)
2. Urethrocutaneous fistula or Urethral diverticulum
3. Meatal stenosis
4. Wound infection, hematoma or dehiscence
Complications if not treated
1. Urine stream deformity
2. Sexual dysfunction associated with curvature
3. Infertility associated with proximal urethral meatus
References
1. Behrman (2000) Nelson Pediatrics, Saunders, p. 1645-7
2. Borer (1999) Urol Clin North Am 26(1):15

Navigation Tree

Please see the Terms and Conditions. Please also see the privacy statement regarding advertising on this page. Although access to this page is not restricted, the information found here is intended for use by medical providers. Patients should address specific medical concerns with their physicians.

This page was written by Scott Moses, MD, and was last revised 1/27/2008. Please send comments and questions to the editor. Contact information may be found on the page About the Family Practice Notebook. These pages are best viewed with Microsoft Internet Explorer 5.0.