|
|
(10 intermediate revisions by the same user not shown) |
Line 1: |
Line 1: |
| {{Header}}
| | #REDIRECT [[Genital Abnormality - Hypospadias]] |
| ==Introduction==
| |
| Hypospadias are the most common penis abnormality (1 in 300) and result from a failure of male urogenital folds to fuse in various regions, the normal process is described as virilization of the external genitalia. This in turn leads to resulting in a proximally displaced urethral meatus or opening. The cause is unknown, but suggested to involve many factors either indivdually or in combination including: familial inheritance, low birth weight, assisted reproductive technology, advanced maternal age, paternal subfertility and endocrine-disrupting chemicals.<ref name="PMID11713004"><pubmed>11713004</pubmed></ref> Infants with hypospadias should not undergo circumcision.
| |
| | |
| == Some Recent Findings ==
| |
| {|
| |
| |-bgcolor="F5FAFF"
| |
| |
| |
| * '''Correction of Distal Penile Hypospadias'''
| |
| ** "The major aims of correction of hypospadias include construction of a neourethra, removal of the chordee, and reduction of the probability of postoperative fistulization. Here, we describe a new technique that can be easily used in cases with subcoronal distal penile hypospadias (even those with chordee) for the construction of the urethra using meatus-based transverse flaps."<ref><pubmed>20548222</pubmed></ref>
| |
| ** "Meatal mobilization (MEMO) by distal urethral preparation has been demonstrated to be an efficient surgical technique for the correction of distal hypospadias offering excellent short-term success rates."<ref><pubmed>20450394</pubmed></ref>
| |
| |}
| |
| | |
| ==Hypospadia Classification==
| |
| [[File:Hypospadia classifications.jpg|thumb|400px|Classification of Hypospadias<ref name="PMID11713004" />]]
| |
| The condition is classified by the general location of the relocated opening (meatus) and lack of fusion.
| |
| | |
| | |
| {|
| |
| |-bgcolor="CEDFF2"
| |
| | width=200px|'''Hypospadia Classification'''
| |
| | '''Meatus Opening'''
| |
| | '''Image'''
| |
| |-
| |
| | Anterior
| |
| | on inferior surface of glans penis
| |
| | A
| |
| |-bgcolor="F5FAFF"
| |
| | Coronal
| |
| | in balanopenile furrow
| |
| | B
| |
| |-
| |
| | Distal
| |
| | on distal third of shaft
| |
| | C
| |
| |-bgcolor="F5FAFF"
| |
| | Penoscrotal
| |
| | at base of shaft in front of scrotum
| |
| | D
| |
| |-
| |
| | Scrotal
| |
| | on scrotum or between the genital swellings
| |
| | E
| |
| |-bgcolor="F5FAFF"
| |
| | Perineal
| |
| | behind scrotum or genital swellings
| |
| | F
| |
| |}
| |
| | |
| ==Surgical Repair==
| |
| | |
| Depending on the class of hypospadias there are a number of different surgical repair techniques including: orthoplasty or penile straightening, urethroplasty, meatoplasty and glanuloplasty, [[S#scrotoplasty|scrotoplasty]] (oscheoplasty) and skin coverage.
| |
| | |
| ==Maternal Factors==
| |
| | |
| Data from a case-control study in Sweden and Denmark (2000 - 2005) identified a number of maternal factors that may be associated with hypospadias.<ref><pubmed>18709149</pubmed></ref>
| |
| * Maternal diet during pregnancy lacking both fish and meat - more than 4-fold increased risk
| |
| * Maternal obesity - more than 2-fold increased risk
| |
| * Maternal hypertension - 2.0-fold increased risk
| |
| * Maternal absence of nausea - 1.8-fold increased risk
| |
| * Maternal nausea in late pregnancy - also appeared to be positively associated with increased risk
| |
| | |
| ==Molecular Factors==
| |
| * chromosomal abnormalities
| |
| * HOX, FGF, Shh - genes of penile development
| |
| * WT1, SRY - testicular determination
| |
| * luteinizing hormone (LH) receptor
| |
| * 5alpha reductase, androgen receptor - action of androgen
| |
| * CXorf6
| |
| * ATF3
| |
| | |
| '''Links:''' OMIM - [http://www.ncbi.nlm.nih.gov/omim/300120 CXorf6]
| |
| | |
| ==Related Genetic Conditions==
| |
| | |
| * X-linked isolated hypospadias-1 [http://www.ncbi.nlm.nih.gov/omim/300633 HYSP1 OMIM 300633]
| |
| * X-linked isolated hypospadias-2 [http://www.ncbi.nlm.nih.gov/omim/300758 HYSP2 OMIM 300758]
| |
| * X-linked isolated hypospadias-3 [http://www.ncbi.nlm.nih.gov/omim/146450 HYSP3 OMIM 146450]
| |
| * Johanson-Blizzard syndrome<ref><pubmed>20556423</pubmed></ref> - hypospadias, failure to thrive, exocrine pancreatic deficiency, short stature and developmental delay, cutis aplasia on the scalp, aplasia of alae nasi, hypothyroidism, myxomatous mitral valve, and patent ductus arteriosus.
| |
| | |
| ==References==
| |
| | |
| <references/>
| |
| | |
| ===Reviews===
| |
| | |
| ===Articles===
| |
| | |
| ===Search Pubmed===
| |
| | |
| June 2010 "Hypospadia" All (4698) Review (377) Free Full Text (413)
| |
| | |
| '''Search Pubmed:''' [http://www.ncbi.nlm.nih.gov/sites/entrez?db=pubmed&cmd=search&term=Hypospadia Hypospadia] | [http://www.ncbi.nlm.nih.gov/sites/entrez?db=pubmed&cmd=search&term=Hypospadia%20Surgical%20Repair Hypospadia Surgical Repair]
| |
| | |
| ==External Links==
| |
| | |
| * [http://www.eurodsd.eu EuroDSD programme]
| |
| | |
| | |
| | |
| | |
| {{Glossary}}
| |
| | |
| {{Footer}}
| |
| | |
| [[Category:Genital]] [[Category:Abnormal Development]] [[Category:Male]]
| |