Hypospadias

Abstract

Hypospadias is a defect in the development of the male genital resulting in an abnormal localized position of the external urethral orifi ce, curvature of the penis, and failed closure of the foreskin in the ventral part of the penis (Fig. 50.1). The urethral orifi ce, usually localized at the glanular tip, occurs ectopic on the ventral side of the glans in so-called distal hypospadias, on the penile shaft in midshaft or penile hypospadias, and in the scrotal or perineal area in so-called proximal hypospadias. Hypospadias is a common birth defect with an incidence of one in 150-300 male births [ 1, 2 ]. Multiple factors were shown to infl uence male genital development disorders: several target genes have been identifi ed to be associated with hypospadias [ 3 ], advanced maternal age was seen to increase severity of hypospadias [ 4 ], placental insuffi ciency [ 5 ] and preterm newborns as well as newborns with low birth weight [ 6 ] were shown to have a higher risk to develop a hypospadias, and fi nally endocrine disruptors are currently discussed to play an important role in the occurrence of genital malformations [ 7 - 10 ]. Hypospadias is often related with other genitourinary malformations like undescended testicles and development disorders like the testicular dysgenesis syndrome [ 11 ].