Clinical Characteristics and Sex Hormone Levels in 323 Cases of Hypospadias With or Without Associated Malformations

Objectives: Hypospadias is one of the most common congenital malformations of the male genitourinary system and is frequently accompanied by other congenital anomalies. Whether patients with associated malformations exhibit distinct endocrine characteristics remains unclear. Methods: A retrospective analysis was performed on 323 hypospadias patients who underwent surgery at Capital Medical University Affiliated Capital Children's Medical Center between January 2020 and September 2024. Data on surgical age, clinical classification, associated malformations, and sex hormone levels were collected. Propensity score matching was used for between-group comparisons. Results: Associated malformations were present in 68 of 323 patients (21.05%), most commonly involving the urogenital system (75.00%). Cryptorchidism was the most common associated anomaly. The surgical age was significantly later in patients with associated malformations (median 3.34 years) compared to those with isolated hypospadias (2.42 years). Following matching, patients with urogenital-related anomalies had significantly elevated FSH and PRL levels (both p < 0.05) compared with isolated hypospadias, whereas no significant hormonal differences were found in those with non-urogenital anomalies. Conclusions: Children with hypospadias and associated urogenital anomalies exhibited subtle differences in endocrine profiles compared with isolated hypospadias. These findings suggest that hypospadias with urogenital anomalies may represent a clinically distinct subgroup and support the need for further prospective studies and long-term endocrine follow-up.