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Published on: October 12, 2017
Developmental anomalies and disabilities associated with hypospadias
Wang-Hseng Wu1, Jiin-Haur Chuang, Ya-Chuan Ting
1Department of Pediatric Surgery, Division of Pediatric General Surgery, Chang Gung Children's Hospital at Kaohsiung, Niao-Sung Hsiang, Koahsiung Hsien, Taiwan, Republic of China.
Insights
Posterior hypospadias, the most common anomaly, is linked to numerous developmental issues. Further research is needed to clarify the impact of these physical and psychosocial disabilities on affected patients.
Area of Science:
- Urology
- Pediatric Surgery
- Developmental Pediatrics
Background:
- Hypospadias is a congenital condition affecting the urethral opening.
- The association between hypospadias and other developmental anomalies/disabilities is not well-established.
- Posterior hypospadias is a specific subtype with varying reported incidences and associated conditions.
Purpose of the Study:
- To evaluate the incidence of developmental anomalies and disabilities in patients undergoing hypospadias repair.
- To analyze the types and frequencies of associated urogenital and extra-urogenital anomalies.
- To investigate the relationship between hypospadias severity (specifically posterior hypospadias) and associated conditions.
Main Methods:
- Retrospective review of 356 patients who had hypospadias repair between 1986 and 2000.
- Data collection included Barcat classification, penile variants, urogenital anomalies, and developmental disabilities.
- Statistical analysis to determine frequencies and associations.
Main Results:
- Posterior hypospadias (65.7%) was the most frequent type.
- Associated anomalies like penoscrotal transposition, bifid scrotum, and undescended testis were common, particularly with posterior hypospadias.
- Extra-urogenital anomalies (e.g., congenital heart disease, musculoskeletal issues) and developmental disabilities (e.g., growth retardation, psychological disorders) were frequently observed, often linked to posterior hypospadias.
Conclusions:
- Posterior hypospadias is the predominant subtype and is associated with a significant rate of extra-urogenital anomalies.
- Patients with posterior hypospadias exhibit a higher incidence of physical and psychosocial disabilities.
- The long-term developmental impact of these associated conditions requires further investigation.
Purpose:
The incidence of developmental anomalies and disabilities associated with hypospadias is still a matter of controversy and data on this issue are sparse. We describe our experience with and evaluation of developmental anomalies and disabilities in a population in which posterior hypospadias was the most common anomaly.
Materials And Methods:
We reviewed the records of 356 patients who underwent hypospadias repair from January 1986 through April 2000. Collected data included the Barcat classification of the hypospadias anomaly, anatomical penile variants, associated urogenital and extra-urogenital anomalies, and associated disabilities of physical and mental development.
Results:
Of the 356 patients 234 (65.7%) had posterior, 88 (24.7%) anterior and 34 (9.6%) mid hypospadias. Anatomical variants, including penoscrotal transposition, bifid scrotum and micropenis, occurred predominantly in patients with posterior hypospadias, while penile torsion was present exclusively in the other 2 groups. Inguinal hernia, which was the most common urogenital anomaly, was distributed evenly among the 3 groups with a prevalence rate of 12.4%. Undescended testis in 26 cases (7.3%) was most often associated with posterior hypospadias. In order of frequency associated extra-urogenital anomalies included congenital heart disease in 19 cases (5.3%), musculoskeletal anomalies in 11 (3.1%), anorectal malformation in 6 (1.7%), cleft palate in 3 and other in 7. In 21 patients (5.9%) associated disorders were related to physical and mental development, including growth retardation in 6, cerebral palsy in 2 and psychological disorders that significantly impaired patient bodily function, behavior and performance in 11. Most extra-urogenital anomalies or disorders were associated with posterior hypospadias.
Conclusions:
Posterior hypospadias was the most common anomaly in this study. It was associated with a high rate of extra urogenital anomalies, and physical and psychosocial disabilities. The significance of the latter findings with respect to the development of affected patients needs further clarification.
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