Hypospadias: Difference between revisions

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'''Hypospadias''' is an absolute contraindication for neonatal [[circumcision]] until a paediatric surgeon evaluates the case.
{{WikipediaQuote|URL=https://en.wikipedia.org/wiki/Hypospadias}}
{{WikipediaQuote|URL=https://en.wikipedia.org/wiki/Hypospadias}}


'''Hypospadias''' is a common variation in fetal development of the [[penis]] in which the [[urethra]] does not open from its usual location in the head of the penis. It is the second-most common birth abnormality of the male reproductive system, affecting about one of every 250 males at birth.<ref name="Snodgrass">{{REFbook
'''Hypospadias''' is a common variation in fetal development of the [[penis]] in which the [[urethra]] does not open from its usual location in the head of the [[penis]]. It is the second-most common birth abnormality of the male reproductive system, affecting about one of every 250 males at birth.<ref name="Snodgrass">{{REFbook
  |last=Snodgrass
  |last=Snodgrass
  |first=Warren
  |first=Warren
  |editor=Allan Wein, Meredith F Campbell, Patrick C Walsh
  |init=W
|editors=Allan Wein, Meredith F Campbell, Patrick C Walsh
  |edition=10
  |edition=10
  |title=Campbell-Walsh Urology
  |title=Campbell-Walsh Urology
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  |chapter=130: Hypospadias
  |chapter=130: Hypospadias
  |isbn=978-1-4160-6911-9
  |isbn=978-1-4160-6911-9
}}</ref> Roughly 90% of cases are the less serious distal hypospadias, in which the urethral opening (the [[Urinary meatus|meatus]]) is on or near the head of the [[Glans penis|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 should have made the urethra extends from the meatus to the tip of the glans; this tissue is called the [[urethral plate]].
}}</ref> Roughly 90% of cases are the less serious distal hypospadias, in which the [[urethra]]l opening (the [[Urinary meatus|meatus]]) is on or near the head of the [[Glans penis|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 should have made the [[urethra]] extends from the meatus to the tip of the glans; this tissue is called the [[urethral plate]].


The prevalance of hypospadias is highest in North America and lowest in Asia.<ref name="vanderhorst2017>{{REFjournal
The prevalance of hypospadias is highest in North America and lowest in Asia.<ref name="vanderhorst2017>{{REFjournal
  |last=van der Horst
  |last=van der Horst
  |first=HJ
  |init=HJ
  |author-link=
  |author-link=
  |last2=de Wall
  |last2=de Wall
  |first2=LL
  |init2=LL
  |author2-link=
  |author2-link=
  |etal=no
  |etal=no
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  |volume=176
  |volume=176
  |issue=4
  |issue=4
  |pages=435-41
  |pages=435-441
  |url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5352742/
  |url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5352742/
  |quote=
  |quote=
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}}</ref>  
}}</ref>  


The foreskin frequently does not develop normally. The ventral portion of the foreskin may not develop so the foreskin takes the form of a dorsal flap.<ref name="vanderhorst2017 />
The [[foreskin]] frequently does not develop normally. The ventral portion of the foreskin may not develop so the foreskin takes the form of a dorsal flap.<ref name="vanderhorst2017 />


==Surgical repair==
==Surgical repair==


Each case must be evaluated to determine how best to proceed. Mild cases may not require repair.  
Each case must be evaluated to determine how best to proceed. Mild cases may not require repair.<ref name="winship-rushton2017>{{REFjournal
|last=Winship
|first=Brenton B.
|init=BB
|author-link=
|last2=Ruston
|first2=H. Gil
|init2=HG
|author2-link=
|last3=Pohl
|first3=Hans G.
|init3=HG
|author3-link=
|etal=yes
|title=In pursuit of the perfect penis: Hypospadias repair outcomes
|trans-title=
|language=
|journal=J Pediatr Urol
|location=
|date=2017-06
|volume=13
|issue=3
|pages=285-288
|url=https://www.jpurol.com/article/S1477-5131(17)30103-1/fulltext
|quote=
|pubmedID=28351650
|pubmedCID=
|DOI=10.1016/j.jpurol.2017.01.023
|accessdate=2019-10-23
}}</ref>


If surgical repair is to be undertaken, then van der Horst & de Wall (2017) recommend that surgical repair be carried out after four months of age and prior to eighteen months of age.<ref name="vanderhorst2017 />
If surgical repair is to be undertaken, then van der Horst & de Wall (2017) recommend that surgical repair be carried out after four months of age and prior to eighteen months of age.<ref name="vanderhorst2017 />
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  |date=
  |date=
  |accessdate=2019-10-21
  |accessdate=2019-10-21
|format=
|quote=
}}
* {{REFweb
|url=https://www.urologyhealth.org/urologic-conditions/hypospadias
|title=What is Hypospadias
|trans-title=
|language=
|last=
|first=
|author-link=
|publisher=Urology Care Foundation
|website=https://www.urologyhealth.org/
|date=
|accessdate=2019-10-23
  |format=
  |format=
  |quote=
  |quote=
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[[Category:Genital surgery]]
[[Category:Genital surgery]]
[[Category:Penile disorders]]
[[Category:Penile disorder]]
[[Category:Literature]]
[[Category:Literature]]
[[de:Hypospadie]]