Pediatrics in Review
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(Pediatrics in Review. 2009;30:235-237. doi:10.1542/10.1542/pir.30-6-235)
© 2009 American Academy of Pediatrics
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In Brief

Hypospadias

The first 300 words of the full text of this article appear below.

Can We Prevent Hypospadias? Baskin LS. J Pediatr Urol. 2007;3 :420 –425[CrossRef][Medline]

Hypospadias: Anatomy, Etiology, and Technique. Baskin LS, Ebbers MB. J Pediatr Surg. 2006;41 :463 –472[CrossRef][Medline]

Hypospadias Surgery: When, What and By Whom? Manzoni G, Bracka A, Palminteri E, Marrocco G. BJU Int. 2004;94 :1188 –1195[CrossRef][Medline]

Hypospadias, derived from the Greek words "hypo" meaning below and "spadon" meaning rent or hole, is defined by a urethral meatus that opens on the ventral surface of the penis proximal to the normal glanular location. Hypospadias is the most common malformation of the male genitalia and occurs in 1 in 300 male births, with some studies demonstrating a doubling of the rate in the United States between 1970 and 1993. Depending on the degree of anatomic defect, affected patients may be unable to urinate while standing and can experience issues regarding body image, sexual intercourse, and relationships. Surgical repair is the only treatment.

A review of embryology is useful in understanding the nature of this defect. As the phallus elongates at 7 to 8 weeks gestational age, the urethral groove develops on the ventral surface of the penis. The two edges of the urethral groove fold together and fuse in a proximal-to-distal direction, forming the urethra, with the meatus located on the glans. Finally, the prepuce originates from the periphery of the glans penis and is complete by 14 weeks’ gestation. Incomplete fusion of the urethral folds results in hypospadias, a urethral opening on the ventral surface of the penis or on the scrotum. The development of the male external genitalia depends on the presence of testosterone and its metabolites as well as a functional androgen receptor.

Despite extensive investigation, the cause of hypospadias remains unknown for most . . . [Full Text of this Article]


Neha Madhok, MD
Kathryn Scharbach, MD
Sara Shahid-Saless, MD
 Children's Hospital at Montefiore, Bronx, NY

Henry M. Adam, MD, Editor, In Brief
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