Peds
Hypospadias
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Hypospadias
See Also
Genitourinary Examination in Infants
Epidemiology
Prevalence
: 4.7 to 8 per male births
Predisposing factors
Family History
Father with Hypospadias: 8% risk
Brother with Hypospadias: 14% risk
Pathophysiology
Congenital defect of
Urethra
l meatus development
Urethra
l folds incompletely fuse
Ectopic
Urethra
l meatus between glans and perineum
Associated conditions
Undescended Testicle
(10% association)
Inguinal Hernia
Hydrocele
Chordee
(ventral penile curvature)
Classification
Anterior (Distal penis and glans): 50% of cases
Middle (Midshaft of penis): 30% of cases
Posterior (
Scrotum
, Perineum): 20% of cases
Management
Avoid
Circumcision
(foreskin needed for repair)
Surgical repair at 6 to 12 months of age
Complications of surgical repair
Complications 5-15% (highest for posterior Hypospadias)
Urethrocutaneous fistula or
Urethra
l diverticulum
Meatal stenosis
Wound Infection
, hematoma or dehiscence
Complications if not treated
Urine stream deformity
Sexual Dysfunction
associated with curvature
Infertility
associated with proximal
Urethra
l meatus
References
Behrman (2000) Nelson Pediatrics, Saunders, p. 1645-7
Borer (1999) Urol Clin North Am 26(1): 15-37 [PubMed]
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