Genital Abnormality - Hypospadia

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. This in turn leads to resulting in a proximally displaced urethral meatus. 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.^[1] Infants with hypospadias should not undergo circumcision.

Hypospadia Classification

Classification of Hypospadias

The condition is classified by the general location of the relocated opening (meatus) and lack of fusion.

Anterior Hypospadia

A Meatus located on inferior surface of glans penis.

Coronal Hypospadia

B Meatus located in balanopenile furrow.

Distal Hypospadia

C Meatus located on distal third of shaft.

Penoscrotal Hypospadia

D Meatus located at base of shaft in front of scrotum.

Scrotal Hypospadia

E Meatus located on scrotum or between the genital swellings.

Perineal Hypospadia

F Meatus located behind scrotum or genital swellings.

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, scrotoplasty and skin coverage.

Related Genetic Conditions

Johanson-Blizzard syndrome^[2] - 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.