Presentation
Hypospadias occurs fairly frequently and is present in approximately 1 out of every 150 to 300 newborn boys. [chop.edu]
SRY gene is located in the Y chromosome and encodes a domain, present in many DNA-binding proteins, which could regulate testicular differentiation. [fertilitypedia.org]
Hypospadias is a condition present from birth in which the opening of a boy’s urethra, the tube that carries urine from the bladder out of the body, isn’t located at the tip of the penis. [nyulangone.org]
Chordee (curvature of the penis with ventral shortening) is often present as well., , 3 Norton M.E. Callen’s ultrasonography in obstetrics and gynecology. [ajog.org]
With 8 simulations of malformation of the urethra, the Hyspospadia Trainer (HPT) allows clinical analysis and surgical considerations for each case, according to its presentation. [gtsimulators.com]
Entire Body System
- Pain
The first week after the operation You should call the ward if: Your child is in a lot of pain and pain relief does not seem to help There is any oozing from the operation site The dressing falls off The amount of urine draining from the catheter is reduced [gosh.nhs.uk]
Give pain relief when needed. Paracetamol may be enough. See our fact sheet Pain relief for children. Give oral antibiotics as instructed. Follow instructions from the doctor about the dressing on the penis. [rch.org.au]
What level of pain should my child expect after hypospadias surgery? Each child’s pain level is different, but typically the most discomfort will occur in the first two to three days after hypospadias repair. [chop.edu]
They will be asleep and not feel any pain. Occasionally, the baby needs two surgeries: one to straighten the penis and one to fix the urethra. But often, the surgeon does it in one procedure. [my.clevelandclinic.org]
Your child may be given medicine to relieve pain. Most of the time, the child can leave the hospital the same day as the surgery. [medlineplus.gov]
- Swelling
The swelling and bruising is typically present two to three weeks after surgery, and may last longer for some boys. [chop.edu]
Medicine 2013 Two goat kids, ranging in age between 3-5months, were referred to the Surgery Clinic at the University of Veterinary & Animal Sciences, Lahore, Pakistan, and showed signs of dysuria, stranguria and urine scalding associated with fluctuating swellings [semanticscholar.org]
There may be swelling and bruising early on. This gets better over a few weeks. Sometimes the skin of the penis heals with what seems like excess or uneven skin. There may also be more obvious complications. [urologyhealth.org]
Add two tablespoons of cooking salt to your child's bath water to help reduce swelling once your child's doctor has advised that your child can have a bath. [rch.org.au]
- Falling
[…] or stops The catheter falls out Looking after the catheter and dressing After the operation, there will be a flexible plastic tube (catheter) in the urethra with a large dressing covering the penis. [gosh.nhs.uk]
[…] becomes infected (looks red, inflamed or is oozing) your child is not passing enough urine – the wee will become very dark in colour if this happens you have any concerns about the catheter, or it comes out before it is due to be removed the dressing falls [rch.org.au]
- Fever
But call your provider right away if you notice: Fever of 102° F or higher for more than 24 hours. Difficulty peeing or inability to pee. Blue or gray discoloration at the tip of the penis. Discomfort despite pain medication. [my.clevelandclinic.org]
Gastrointestinal
- Nausea
Anesthesia can cause nausea or vomiting in… Hypospadias Hypospadias is a birth defect of the male urethra that results in the urethral meatus (opening) being positioned in an abnormal location on the ventral (underside) aspect of the penis. [urology.ufl.edu]
- Vomiting
If vomiting occurs, return to the clear liquid diet and progress slowly. [urology.ufl.edu]
Psychiatrical
- Suggestibility
Studies of boys with uncorrected hypospadias suggest that this can lead to lower self-esteem. Most pediatric urologists today suggest fixing all but the most minor forms of hypospadias. [urologyhealth.org]
This commentary critically examines allegations suggesting a worldwide increase in hypospadias rates. [jpurol.com]
Etiology Several etiologies for hypospadias have been suggested, including genetic, endocrine, and environmental factors. [emedicine.medscape.com]
The doctor will suggest delaying circumcision and refer you to a urologist In some cases, the penis also curves in a downward arc, something doctors call chordee. It shows during an erection. [webmd.com]
Some research suggests that there may be an increased risk of hypospadias in infant males born to women older than 35 years. Exposure to certain substances during pregnancy. [mayoclinic.org]
Urogenital
- Chordee
Chordee Without Hypospadias Chordee can be present without hypospadias. It is often found when parents bring their children to the doctor due to a bend in the penis. Often, chordee alone is caused by skin tethering. [beaumont.org]
A condition called chordee is often seen with hypospadias. Chordee is a downward curve of the penis. This can occur with or without a hypospadias. [cincinnatichildrens.org]
Hypospadia are often associated with a ventral curvature of the penis (chordee) and/or a deficient ventral prepuce (foreskin) with a dorsal "hood". [urology-textbook.com]
In children with hypospadias, symptoms include: Chordee: Penis curves downward. [my.clevelandclinic.org]
Also, a downward bending of the penis, commonly referred to as chordee, may occur. Chordee is found in 10% of distal hypospadias and 50% of proximal hypospadias cases at the time of surgery. [encyclopedia.uia.org]
- Cryptorchidism
Cryptorchidism (undescended testicles) and inguinal hernia are the most commonly associated anomalies. [fertilitypedia.org]
Associations Associated anomalies are common and include: congenital vesico-ureteral reflux cryptorchidism inguinal herniation Syndromic associations include: Aarskog syndrome genito-palato-cardiac syndrome Roberts syndrome Smith-Lemli-Opitz syndrome [radiopaedia.org]
Diagnostic work-up of Hypospadias Basic Investigations: In addition to a careful physical examination (position of the meatus, open processus vaginalis, cryptorchidism, signs of DSD), ultrasound imaging of the urinary organs is necessary. [urology-textbook.com]
Chromosomal anomalies in cryptorchidism and hypospadias. Urol Int. 1991; 47(2): 60-63. Shima H, Ikoma F, Terakawa T, Satoh Y, Nagata H, Shimada K et al. Developmental anomalies associated with hypospadias. J Urol. 1979; 122(5): 619-621. [medigraphic.com]
It has previously been mentioned as possibly participating in a three-gene interaction influencing hypospadia, cryptorchidism and/or omphalocele [19]. [molecularcytogenetics.biomedcentral.com]
- Urinary Retention
On the other hand, stents prevented temporary urinary retention which occurred in 2 patients in the non-stented group. [karger.com]
- Dysuria
Bokhari Medicine 2013 Two goat kids, ranging in age between 3-5months, were referred to the Surgery Clinic at the University of Veterinary & Animal Sciences, Lahore, Pakistan, and showed signs of dysuria, stranguria and urine scalding associated with [semanticscholar.org]
Treatment
If the pediatrician detects hypospadias, they’ll refer you to a pediatric urologist for treatment. Hypospadias repair can correct the problem. Management and Treatment How is hypospadias treated? Surgery can correct hypospadias. [my.clevelandclinic.org]
Some patients with hypospadias do not undergo any treatment besides observation, due to no symptoms or patient / family preference. [cincinnatichildrens.org]
Diagnosis and treatment Diagnosis and treatment Mild forms of hypospadia, in which normal sexual activity and a normal urine jet can be expected, often do not require treatment. [mariamiddelares.be]
Treatments Treatment for hypospadias depends on the type of defect the boy has. Most cases of hypospadias will need surgery to correct the defect. If surgery is needed, it is usually done when the boy is between the ages of 3–18 months old. [cdc.gov]
Ahmed Hadidi Position: CHAIRMAN PEDIATRIC SURGERY Specialist in Hypospadias HYPOSPADIAS Information about the Hypospadias-surgery PEDIATRIC SURGERY Information, meeting, treatment PROF. DR. HADIDI’S BLOG Blog and information about Prof. Dr. [hypospadie24.com]
Prognosis
Prognosis Results after surgery are most often good. In some cases, more surgery is needed to correct fistulas, narrowing of the urethra, or a return of the abnormal penis curve. [klinikadigjitale.net]
Prognosis The most frequent complications of hypospadias are stenosis of the urethral meatus and difficulty controlling the urinary stream. Hypospadias is treated with surgery. Prognosis is very favorable among cases of isolated hypospadias. [ajog.org]
Outlook / Prognosis What is the outlook for children with hypospadias? Hypospadias (and chordee) repair procedures are very successful. Most repairs last a lifetime. The penis has a normal, healthy function. [my.clevelandclinic.org]
Subsequent assessment revealed a more balanced incidence among different race groups. [19] Prognosis With modern anesthetics, instruments, sutures, dressing materials, and antibiotics, hypospadias repair is considered generally successful. [emedicine.medscape.com]
Etiology
In addition to the known enzyme defects (see above), most genes involved in the etiology of hypospadias are still unknown. [urology-textbook.com]
Etiology Many hypotheses have been proposed concerning the etiology of hypospadias, including genetic predisposition, inadequate hormonal stimulation prenatally, maternal-placental factors, and environmental influences. [ncbi.nlm.nih.gov]
Google Scholar, A variety of genetic, endocrine, and environmental etiologies have been proposed that may increase the risk of hypospadias. [ajog.org]
Etiology Several etiologies for hypospadias have been suggested, including genetic, endocrine, and environmental factors. [emedicine.medscape.com]
[…] dermatopathology and pathology + Atlas of fetal pathology + Congenital malformations + Physiological developement of an embryo and fetus, growth and changes of the external shape + Congenital malformations and congenital anomalies + Basic terminology + Etiology [atlases.muni.cz]
Epidemiology
Epidemiology The prevalence of hypospadias in Europe is approximately 18.6 per 10,000 births. [ncbi.nlm.nih.gov]
The classification of hypospadias depends on the position of the urethral meatus: Glanular Coronal Penile (distal-middle-proximal) Scrotal Perineal Epidemiology of Hypospadias 1–8/1000 births. Distal hypospadias are more often. [urology-textbook.com]
A joint international study on the epidemiology of hypospadias. Acta Paediatr Scand Suppl. 1986. 324:1-52. [QxMD MEDLINE Link]. Yu X, Nassar N, Mastroiacovo P, et al. [emedicine.medscape.com]
Pathophysiology
Pathophysiology Hypospadias is a congenital defect that is thought to occur during the embryologic development of the urethra, between 8 and 20 weeks' gestation. [emedicine.medscape.com]
Prevention
CDC funds the Centers for Birth Defects Research and Prevention, which collaborate on large studies such as the National Birth Defects Prevention Study (NBDPS; births 1997-2011) and the Birth Defects Study to Evaluate Pregnancy exposureS (BD-STEPS; began [cdc.gov]
He will be prescribed a medication to prevent bladder spasms during this time as well as an antibiotic to prevent infection. The most common complication of surgery is an urethrocutaneous fistula, or an opening between the urethra and penile skin. [texaschildrens.org]
Prevention Can I prevent hypospadias? Pregnant people can reduce the risk of their baby having hypospadias by practicing a healthy lifestyle: Don’t smoke or drink alcohol. Maintain a healthy weight. [my.clevelandclinic.org]
Centers for Disease Control and Prevention. http://www.cdc.gov/ncbddd/birthdefects/hypospadias.html. Accessed Aug. 14, 2016. Bouty A, et al. The genetic and environmental factors underlying hypospadias. Sexual Development. 2015;9:239. Riggin EA. [mayoclinic.org]
Can we prevent hypospadias?. Fertil. Steril. 2008; 89: e39 Rocheleau C.M. Romitti P.A. Dennis L.K. Pesticides and hypospadias: a meta-analysis. J. Pediatr. [jpurol.com]