What is hypospadias?

Hypospadias: the causes of disease and treatment - All About Health

hypospadias - malformation of the genitourinary system in men, characterized by proximal displacement of the outer opening of the urethra at the base of the glans, in the region of coronal sulcus, shaft of the penis, scrotum, perineum.

Hypospadias is accompanied by a curvature of the penis, urination disorders, irritation of the skin of the perineum urine, psychological discomfort, sexual dysfunction. Diagnosis of hypospadias include visual inspection, holding ultrasound of the scrotum and penis, ureteroscopy, urethrography, uroflowmetry.

Hypospadias correction is performed surgically using urethroplasty.

Hypospadias - a congenital anomaly of the penis and urethra, accompanied by dystopia meatus on the ventral surface of the penis. Hypospadias is one of the most common malformations of the lower urinary tract in men, inferior in frequency only meatostenozu and phimosis.

In pediatric urology hypospadias occurs with a frequency of 1 in 500-400 of male births, accounting for 1-4% of all urological pathology. Unlike male hypospadias female hypospadias is considered an extremely rare disease, located at the junction of urology and gynecology.
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As part of this review we will consider various forms of hypospadias in boys.

Causes of hypospadias

It is known that the formation of hypospadias due to violation of embryogenesis on 7-14 week of pregnancy, namely deviation of the normal course of the processes of differentiation of germinal epithelium and the closure of the urethral Trench. Among the factors causing such disorders are called endocrine disorders in pregnant women, fetal effects of alcohol, drugs and toxic chemicals, early toxicosis pregnancy and others.

According to studies, the most frequent formation of hypospadias observed in children conceived by IVF, such as pregnancy often occurs with complications. Often hypospadias is a component of chromosomal disorders (Edwards Syndrome, Patau Syndrome, a syndrome of "cat cry"). Family history of hypospadias occur in 10-20% of cases.

Classification

Given the degree of maldevelopment urethra distinguish following hypospadias:

capitatum - external opening of the urethra is opened on the basis of the glans penis;
the crown - the external opening of the urethra opens in the coronal sulcus;
stem - external opening of the urethra opens on the trunk of the penis;
scrotal - external opening of the urethra opens on the scrotum;
crotch - the external opening of the urethra opens into the perineum.

Besides these forms, it meets the so-called "hypospadias without hypospadias" (hypospadias of chord type), with which has a deformation of the corpora cavernosa of the penis with the right arrangement of the external opening urethra.

Capitatum and the crown shape refer to the front of hypospadias; stem - to the average; scrotal and perineal - to the rear. Various hypospadias may be combined with the curvature of the penis (ventral, lateral, dorsal, rotational) and obstructive voiding type.

capitatum form Hypospadias occurs in 75% of cases and is the easiest and most common form of vice. Outside the opening of the urethra is located lower, usually narrowed (meatostenoz), making it difficult urination. There may be a curvature of the penis, increasing with the onset of sexual activity
The crown shape hypospadias is accompanied by violation of urination and a pronounced curvature of the penis. Urine is released in a thin stream, with the effort; child constantly wets himself to his feet, forcing him during urination lift up the penis.
stem form hypospadias can have several embodiments, as the orifice can be located at different levels rear surface of the penis. Urination male pattern (standing) very difficult: children have to urinate sitting or pulling the penis up towards the stomach. Significantly pronounced deformation of the penis, painful erections noted. Sex life in this form of hypospadias is possible, however, if the external opening of the urethra is closer to the base of the penis, then during ejaculation sperm enters the vagina.
scrotal form Hypospadias is the most severe manifestation of the disease. Meatus opens on the scrotum, splitting it into 2 parts. The penis is underdeveloped and sharply curved, resembles hypertrophic clitoris; scrotum is similar in appearance to the labia majora. At birth, boys with this form of hypospadias may be mistaken for girls with adrenal syndrome (congenital adrenal hyperplasia). Urination at scrotal hypospadias can only be done while sitting; due to the underdevelopment of the deformation of the penis and sex life becomes impossible. scrotum urine causes irritation of the skin redness and inflammation.
perineal form characterized by an arrangement of hypospadias meatus behind the scrotum. Patients determined by a small penis, the splitting of the scrotum, which is often difficult to determine the sex of the child accessories. Perineal and scrotal hypospadias forms often than others, combined with cryptorchidism, inguinal hernia, hydrocele.
when hypospadias on the chord type there is a short underdeveloped urethra is lit curvature of the penis downward. Meatus while positioned correctly. During erection penis is curved in the shape of a bow, accompanied by a painful, difficult or impossible sexual intercourse.
Women hypospadias characterized ectopia vaginal meatus and is accompanied by recurrent urinary infections tracts (cystitis and urethritis), vulvitis and vulvovaginitis, often - signs and hermaphroditism pseudohermaphroditism.

A careful examination of the newborn neonatologist to diagnose hypospadias shortly after birth.

For proper sexing newborn with abnormal genitalia is necessary to conduct a pelvic ultrasound, in some cases - the definition of the karyotype.

Since hypospadias may be accompanied by more than 100 genetic syndromes, the child should consult a geneticist.

Further examination and supervision of a child with hypospadias carried pediatric urology, pediatric endocrinology, pediatric gynecologist. On examination, the patient with hypospadias draws attention to the location of the meatus, its size and shape; it turns out the nature and extent of urination, presence of penile curvature during erection, especially sexual intercourse.

Since hypospadias often combined with other malformations of the urinary system (vesicoureteral reflux, hydronephrosis et al.), Children shown renal ultrasound and ultrasound of the bladder. When examining children with hypospadias may require special studies: ureteroscopy, urethrography, uroflowmetry, MRI of the pelvic organs.

treatment of hypospadias

Treatment of hypospadias is a challenge urology and plastic surgery, pursuing the goal of restoring the functional usefulness of the penis and eliminate cosmetic defects.

In this case, preference is given to the early timing of surgical intervention (1-3 years.). Currently used a large number of one-stage surgical procedures and phased hypospadias correction.

When meatus with minor dystonia meatostenozom can restrict execution meatotomy; in other cases, it is shown holding the urethra plastics using local flaps and free grafts.

The main stages of the operation are at hypospadias correction of penile curvature, recreating the missing urethra (urethroplasty) and normally placed meatus (meatoplastika).

If cryptorchidism is performed simultaneously bringing down the testis into the scrotum.

Postoperatively urinary diversion is carried out by catheterization of the urinary bladder cystostomy or overlay for 7-14 days. If necessary, after removing the urethral catheter is held probing.

Forecast

Surgical treatment of hypospadias achieves good functional and cosmetic result in the 75% -95% of cases. Early hypospadias correction restores the normal urination character, full development of the penis, with the exception of injury to the child's psyche.

Complications of surgical correction of hypospadias may be urethral stricture, urethral diverticulum, fistula of the urethra, the loss of sensitivity of the penis head. Complications often arise in the proximal hypospadias (scrotal, perineal).

Children who have undergone surgical correction of hypospadias, observed pediatric urologist to complete the growth of the penis. At this time, in children and adolescents need to follow the nature of urination, urine and spray form an erection.

A source: http://www.krasotaimedicina.ru/diseases/children/hypospadias

Hypospadias - is the most commonly encountered in clinical practice, the violation of the structure of the urethra in male patients. Due to congenital disorders urethra structure, meatus urinarius (external opening of the urethra) is atypical in place, ie. E. not on the head and on the back surface of the penis or in the scrotum.

In the last few decades, this pathology has become fixed at an alarming rate. If half a century ago hypospadias in newborn boys met on average one out of 500, but now is celebrated four times as likely (1: 125)!

Clinical signs Hypospadias What causes hypospadias? Comorbidities Classification Symptoms - Symptoms capitate hypospadias - Symptoms of coronary hypospadias shape - Stem (penile) hypospadias - scrotal hypospadias symptoms - Symptoms crotch hypospadias - without Hypospadias 6 hypospadias. treatment of hypospadias Recommended: Surgery for hypospadias the child: types, complications, rehabilitation

Clinical signs of hypospadias

The main sign of hypospadias - misplacement meata (offset external opening of the urethra in proximal direction) from the position in the scrotum, perineum, trunk or coronal sulcus penis.

The following symptoms may occur:

more or less pronounced curvature of the corpora cavernosa of the penis;
dysplasia of the foreskin - cleavage overhang in the form of a hood.

See also:What is a congenital curvature of the penis

Important: the degree of curvature is usually determined in the course of surgical intervention during the test "an artificial erection."

What causes hypospadias?

Etiology to date not been adequately studied.

Among the major predisposing factors experts call:

pinpoint gene mutations caused by environmental degradation;
genetic predisposition (described cases of children born with this pathology in several generations of the family);
presence-disruptor compounds (destroyers androgens) in products that consumes expectant mother;
hormonal drugs, shown with the threat of termination of pregnancy;
hormonal agents for the prevention of pregnancy in less than a year before conception.

Please note: to disruptors are substances that are used in the processing of food crops (pesticides, fungicides and herbicides). They are able to have a negative impact on the intrauterine development of the child, in particular - on his hormonal status.

It is believed that IVF (in vitro fertilization procedure) risk of birth of a boy with hypospadias increased, as the expectant mother takes estrogen.

It is not excluded as the negative impact of stress, which suffered a mother during gestation, lack protein in her diet, alcohol consumption, nicotine addiction and the use of certain pharmacological drugs.

Accompanying illnesses

Quite often urethral malformation combined with unilateral or bilateral undescended testes in the scrotum, inguinal hernias as well as pathologies such as urogenital sinus inverse vesicoureteral casting urine (reflux) and hydronephrosis.

Due to the high probability of having evolved in parallel pathologies in organs of the excretory system before elective surgery necessarily carried ultrasound.

Upon detection of concomitant disease in the first place it shows their surgical treatment and only then - plastic urethra.

In some cases, it may also require genetic testing to determine the karyotype. It is necessary to identify the true (genetic) sex of the child.

Classification

The following forms of pathology are determined according to the adopted classification:

Front (capitatum and the crown shape);
average (stem);
rear (scrotal and perineal);
"Hypospadias without hypospadias" (a chord).

symptoms

Symptoms of hypospadias is largely dependent on the shape of the existing pathology

Signs capitate hypospadias

When the variety structure anomalies urethral meat markedly shifted in the proximal direction toward the coronal sulcus. The curvature of the corpus cavernosum members are usually not very pronounced, but the foreskin is in the vast majority of observed cases split. Patients complain of external defects, and a thin stream when urinating.

Symptoms of coronary forms of hypospadias

This form of hypospadias different location opening of the urethra directly to the coronal sulcus. A characteristic feature protrudes view foreskin: it has the shape of a hood and is displaced to the dorsal surface of the penis. Patients complain of narrowing mealnogo holes and problems during urination.

Stem (penile) hypospadias

Meat is located on the barrel of the penis (placement levels may be different). When this sort of pathology observed a pronounced change in the shape of the penis, t. E. their curvature.

Symptoms scrotal hypospadias

Meat urethra injected into the scrotum. Often it fixed, not only the curvature, but also the location of the abnormal penis. the patient's genitals have resemblance to the female genital organs. When this sort of disease necessarily requires consultation of the endocrinologist and geneticist.

Signs of perineal hypospadias

For this form of characteristic accommodation meata in the perineum, the splitting of the scrotum and pronounced violation of the structure of the corpus cavernosum of the penis. Genitals often have a mixed structure, ie. E. present features characteristic of both sexes. Often the question of the true sex of the patient supplies.

Hypospadias without hypospadias

Defect "in the form of a chord" is different from other versions of this congenital pathology normal anatomical position of the hole and underdevelopment itself urethra. Typically, penile curvature is quite large, but it is often caused exclusively by a local violation of the structure of the skin. Often marked by the presence of bands of connective tissue along the urethra.

treatment of hypospadias

hypospadias treatment involves surgical intervention in early childhood.

The most suitable for the reconstruction of the urethra and plastic corpora cavernosa is the period of life of a boy six months old to 3-4 years.

Most early operated children practically do not retain memories of the intervention is to minimize the likelihood of psychological problems.

The objectives pursued by the surgery:

correction form the corpus cavernosum of the penis;
forming the missing portion of the urethra;
meata offset to the top of the glans penis;
the most complete elimination of cosmetic defects.

Important: successfully implemented at hypospadias surgery allows the urethra after the plastics normally grow in parallel with the surrounding tissues. The absence of cosmetic defects in the future will save a man from the psychological problems of adaptation in society.

At present, these operations are carried out in one step; modern methods of carrying out more than 95% of cases can achieve perfect results, both from the physiological and from cosmetics.

Very important also is the fact that, after a timely surgical treatment, patients in the future no problems with erectile function and sexual intercourse.

More details about the symptoms, causes and treatment of hypospadias in this video review said the surgeon:

Olga Chumachenko, pediatrician

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(58 vote., 4,80

A source: http://vse-ozdorovie.ru/gipospadiya-prichiny-zabolevaniya-i-lechenie.html

Hypospadias: Symptoms and Treatment

Category: Men's zabolevaniyaProsmotrov: 5775

strangury
Pain during erection
Chordee
The reduced size of the penis
Underdevelopment of the penis
Skin irritation in the penis
opening of the urethra behind the scrotum
urethral opening in the scrotum

Hypospadias - a congenital disease of character, which is characterized by impaired genital structures in men. This disease causes that disturb the natural shape of the penis in men and, as a consequence, the process of urination. In addition, the pathology of the patient gives the psychological discomfort and leads to sexual dysfunction.

According to the international classification of diseases hypospadias in boys related to congenital anomalies (malformations) and has a separate code of ICD-10 - Q54.

Due to the specific clinical diagnosis of this disease does not cause difficulty, but to clarify the diagnosis and detection of possible complications spend instrumental examination. Treatment is only operable one of folk remedies are not talking because they are fully inappropriate.

Etiology

Hypospadias in children is entirely innate character, making external etiological factors in this case can not be.

It should be noted that to date the exact etiological causes of this congenital disease is not established, therefore, no effective prevention methods. However, clinicians identified a number of predisposing factors for the development of this disease in males:

alcohol abuse and receiving narcotic drugs by the mother during gestation;
effects on the mother's body, and, hence, child, or toxic chemicals. This may be the case if the woman works in hazardous work, being already pregnant, or take "heavy" medicated preparations;
chromosome as a complication of diseases;
if the child was conceived by IVF;
multiple pregnancy;
frequent labors;
intrauterine infection;
genetic predisposition.

Cases of familial disease occurs in about 10-20%.

In more rare cases, to establish a possible etiological factor is not possible.

Classification

Depending on the finding of the urethra and hypoplasia isolated forms of congenital pathologies:

the crown;
capitatum;
stem;
scrotal hypospadias;
crotch.

The crown shape and capitatum classification refers to the forward type of the disease, stem form It is regarded as the average hypospadias, scrotal and perineal and refer to the rear sight pathology.

Separately isolated shaped pathology as "hypospadias without hypospadias." In this case, it is meant that the urethra is underdeveloped and shorter than the penis. However, the location of the urethra is in the right place, but due to the difference in length of the penis and urethra, there is a curvature of the body.

Regardless of what type was diagnosed in a man or child, treatment will only be operable.

hypospadias

symptomatology

In this case, the clinical picture will depend on hypospadias. Common clinical symptoms include the following:

shortness of urination;
irritation of the skin in the area of the penis;
deformation of the penis, which can be enhanced with the start of conducting sexual life.

Scrotal hypospadias characterized as follows:

severely underdeveloped penis and its appearance more reminiscent of the clitoris;
urethral opening is located on the scrotum and thus splits it into two parts;
urination is possible only in a sitting position;
traditional sexual life impossible.

It should be noted that this is the most complex form of pathology.

See also:Treatment and symptoms in men ureaplasmas

When perineal hypospadias observed the following:

urethral opening is located behind the scrotum, which leads to splitting it into two parts. This factor often leads to the fact that there are difficulties in determining the sex of the newborn;
penis is small, which makes it difficult to have sexual intercourse.

This form of congenital disease characterized by a high risk of associated complications - inguinal hernia, hydrocele, cryptorchidism.

Stem hypospadias is characterized by a clinical picture:

urethral outlet may be located at different levels rear surface of the penis;
urination passes or sitting, or standing, but tightens the body to the stomach;
the apparent curvature of the penis;
painful erections;
may have difficulty conceiving a child, as the location of the urethra can lead to the fact that semen will not fall into the vagina. But on the whole sexual life is possible.

When the crown shape of the observed pathology of the following nature:

deformation of the external genitalia;
urine is released thin stream, with the effort.

Capitatum form of the disease occurs most commonly, about 75% of cases, and almost never leads to the development of serious complications from the urogenital system. This form of pathology is characterized as follows:

urethral orifice is located low, often narrowed;
shortness of urination;
with the onset of sexual activity can progress curvature of the penis.

We should also highlight shaped pathology as hypospadias of chord type. In this case, the urethra is the bottom. During erection penis can bend the arc, making sexual intercourse impossible, and is accompanied by severe pain.

symptoms of hypospadias

Diagnostics

Due to the fact that the clinical picture is quite specific problems with diagnosis is not seen.

In this case, you may need advice of doctors:

urologist;
endocrinologist;
surgeon;
neonatologist;
geneticist.

The following diagnostic program can be assigned to confirm the diagnosis:

definition karyotype;
Pelvic ultrasound;
Pelvic MRI;
US kidney and bladder.

Laboratory diagnostic methods, in this case, is not carried out, as they do not constitute any diagnostic value.

Treatment

Regardless of the type of illness and the patient's age, urology provides only one most effective elimination of a congenital pathology - surgery.

Correction of pathology and conducting plastics it is recommended to carry out at an early age - from 1 to 3 years. Operations at a later age heavier tolerated.

In the postoperative period diversion of urine is carried out by catheterization and overlaying cystostomy. Such events are shown to the patient for 7-14 days. Sexual activity in this time (when appropriate age) is completely eliminated.

Forecast

With timely intervention operable positive result (both in physiological and cosmetology background) is possible to reach in 75-95% of cases.

possible complications

If no operation is possible complications following

poor sensitivity of the glans penis;
fistula formation;
urethral stricture;
diverticulum of the urethra.

Children who have had surgery before the end of the growth of the penis, should be observed at the urologist.

Since this is a congenital abnormality, no specific prevention methods.

Diseases with similar symptoms:

Phimosis (coincident symptoms: 2 of 8)

Phimosis - a "man's" disease characterized by the inability to expose the glans penis. Phimosis, the symptoms of which can be considered both as a normal physiological manifestations, and in as pathological manifestations may be congenital in nature depending on the occurrence or purchased.

... Chronic prostatitis (coincident symptoms: 2 of 8)

Chronic prostatitis - inflammation that attacks prostate tissue and results in the failure of its normal functioning. Illness is one of the most common disorders among the male genital organs.

... Appendicitis (overlapping symptoms: 1 of 8)

Appendicitis - is an inflammatory process that attacks the appendix is located in the area of the cecum, the appendix is called the appendix.

Appendicitis, the symptoms of which may differ depending on whether an acute form is manifested in inflammatory or chronic, and in the latter form it is now is not as common, and mostly only for the reason that it is impossible to remove the appendix due to development complications.

... Prostatitis (overlapping symptoms: 1 of 8)

Prostatitis is a disease in which the prostate gland becomes inflamed. Prostatitis, symptoms of which are more common in men of reproductive age (20-40 years), on average, are diagnosed in 35% of the population. Depending on the origin, prostatitis may be bacterial or nonbacterial, depending on the nature of the flow - acute or chronic.

... Gonorrhea (overlapping symptoms: 1 of 8)

Gonorrhea is a sexually transmitted disease infectious nature, characterized mucous urogenital organs, the mouth, eyes and rectum. It affects this disease, both male and female population, so the symptoms of gonorrhea for each of them are different.

…

A source: http://SimptoMer.ru/bolezni/muzhskie-zabolevaniya/2525-gipospadiya-simptomy

What is hypospadias?

Hypospadias - a congenital disease associated with the formation of organs of the male reproductive system. Extremely rare, this disease occurs in newborn girls.

As a rule, it is meant underdevelopment of the urethra, which occurs due to violations of fetal development urethral channel.

Often, hypospadias detected against the background of other defects of the genitourinary system: cryptorchidism, gipoginetalizmom, false hermaphroditism, etc.

Such diseases as hypospadias causes anomalies in the structure of the genital organs. It recognizes still in its infancy.

However, there are times when all of the classic symptoms of hypospadias have a place to be, in the absence of the characteristic shortening of the urethra. That is, the urethral opening is located exactly where it should be.

In this case, we have a "hypospadias without hypospadias" - a condition that requires prompt surgical intervention.

Because the disease is among the birth, it is diagnosed in the early days of baby life. A severe form of the disease may cause difficulties in recognizing the newborn gender.

Thus, underdeveloped penis can be taken as a fairly developed clitoris. The misleading doctors and introduces a crease on the scrotum, which is often taken as the vagina.

However hypospadias pretty quickly makes itself known, making it difficult at the time of urination.

Forms of the disease and their main differences

Capitatum hypospadias. For this type of hypospadias typical arrangement of the urethra in the glans, with a characteristic shift in either direction. Most often, you can meet downward bias. In rare cases, the penis may have an irregular shape, to be curved or bent.
This situation occurs in 60-70% of all cases of diagnosed illness. Capitatum hypospadias refers to the least severe forms of the disease, so it does not require correction.
Stem hypospadias. More severe abnormalities. In this case, the opening of the urethra may be placed in the lower part of the penis.
The organ itself, in most cases, is curved and tapered. In some cases, a stenosis of the urethral opening. The characteristic symptoms of a violation of urination.
Scrotal hypospadias. Anomaly, characterized by arrangement of opening of the urethra at the bottom of the scrotum.
At the same time, the penis may be very poorly developed. This casts doubt on newborn sexual identity. That children with scrotal hypospadias, often mistaken for a girl. Underdeveloped penis doctor, by mistake, the doctor recognized as a well-developed clitoris.

However, on closer examination and appropriate diagnosis, identify the anomaly is not difficult.
Hypospadias the crown. This disease is quite rare. Hole urination channel disposed in coronal sulcus.
The characteristic features of a deformation of the penis, impaired micturition (urine stream is directed feet). Rectify the situation can only be timely surgical intervention.
Perineal hypospadias. This form of the disease, as well as the previous one, is extremely rare.
In it, the passage opening may resemble an extended funnel positioned in the crotch area. This type of hypospadias refers to the extremely difficult. newborn sex organ has expressed structural defects, it is twisted, bent, reduced in size.
Okolovenechnaya hypospadias.
In this case, the urethral opening is near the neck of the glans penis. This pathology is very common.
Hypospadias type of chord. Channel urethra developed unworthily, its duration is several times less than the norm. However, the hole itself is exactly where it should be normal. Characteristic signs are embryonic scars in the urethra, the curvature and shortening of the penis.

The causes of the disease

Because hypospadias refers to the number of congenital anomalies, its causes lie in the violation of embryonic development. There are many assumptions about what exactly can cause developmental defects. Among the most popular hypotheses:

hormonal disorders in women (mothers);
ecological problem;
measles, acute respiratory disease in a severe form, as well as some other diseases transferred during pregnancy;
taking potent hormonal drugs, with significant estrogenic activity.

Also, there is a perception that hypospadias occurs in babies whose mother, being pregnant, abused hair lacquers containing phthalate. However, this hypothesis has not been confirmed through research.

However, harmful and corrosive substances that make up the majority of styling, enter the body of a pregnant woman during inspiration.

With regular use, they can accumulate and negatively affect fetal development.

Treatment

When talking about a mild form of the disease, such as hypospadias capitate, then surgical intervention may be necessary. However, the constant supervision of a physician, in the further development of the urogenital tract, nevertheless, required.

More severe forms of the disease, which include perineal, scrotal hypospadias and the crown are the indications for surgery. Hypospadias surgery is performed between the ages of six months to two years.

However, cases are known and highly successful treatment of the disease in adulthood and even old age. The main indications for surgery are more aesthetic than a life-threatening patient and health reasons.

A source: http://mujikzdorov.ru/andrologiya/bolezni-krajnej-ploti/gipospadiya-prichiny-formy-zabolevaniya-lechenie.html

Hypospadias in children

Hypospadias called congenital anomaly urethra (MC). This is a fairly common birth defect, he is seen in 3 children per 1,000 live births, and has been an increase of this pathology. The defect is the absence of the posterior wall of the urethra or MC. Dominated by this pathology in boys in girls is very rare.

Causes

The causes of this disease in children is not fully installed. Experts believe that it can lead to:

genetic disorders in the form of gene mutations;
hereditary factor (sometimes a congenital defect of development occurs in several generations);
hormone therapy, prescribed to women with threatened miscarriage;
hormonal disorders in pregnant in a period of 9-12 weeks (in the gestational period occurs tab urogenital organs of the fetus);
hormonal contraception, used during the year before pregnancy;
In vitro fertilization (during pregnancy is often used hormone replacement therapy);
ecological disasters;
Eating foods that contain herbicides and pesticides that may affect the hormones of the fetus.

symptoms

Normally, the outer opening is located on top of MK glans and, if it can be detected hypospadias on the bottom surface of the penis in the area of its barrel, in the coronal sulcus, in the scrotum or in the region perineum. Depending on this distinguish these forms of the disease:

golovochnaya;
stem;
scrotal;
the crown;
the crotch;
"Hypospadias without hypospadias."

Girls with such pathology hole MK is in the vagina.

Golovochnaya form (most lightweight) occurs in 75% of cases. Perineal and scrotal form are serious malformations. In any form of distortion of notes (in varying degrees of severity) of the penis. This is due to mismatch of the shortened length of MK and the normal length of the corpora cavernosa of the penis.

One of the constant symptoms of vice is also dysplasia foreskin: it can be cleaved or is located on top of the penis, hanging in a "hood".

Hypospadias can be self-developmental abnormalities, and can be combined with other, more serious birth defects (and not only the urogenital system). Isolated defect expressed milder forms ( "hypospadias without hypospadias" golovochnaya form).

Often there is a combination of severe hypospadias and male or female psedogermafroditizma in which the internal sex organs of one sex, and the outer - the opposite. Can meet and other disorders of the urogenital system: vesicoureteral reflux, cryptorchidism, urogenital reflux, hydronephrosis and others.

When capitate form anomalies foreskin is underdeveloped. opening of the urethra (often narrowed) is at the head of the penis, some not reaching its apex. The curvature of the corpora cavernosa of the penis expressed slightly. The child's parents complain of a modified form of the penis and recovering a thin stream of urine.

For typical crown shape defect location external narrowed opening MK in coronal sulcus. Foreskin sags in the form of a "hood". Urine stream is directed at an angle to a curved penis.

When the stem form the urethra opens on the different levels of the stem substantially curved penis. To urinate standing child has to put off the penis to his stomach.

When scrotal or member scrotal anomalies MK hole located on the stem between the scrotum or penis and scrotum. Curvature of the penis pronounced, there is atypical of its location in some cases. Urination is only possible in a sitting position. In the external genitalia significant similarity with large labia and clitoral enlargement.

The crotch shape malformation has the following manifestations: opening of the urethra is on the perineum, the scrotum has a cleavage and a pronounced curvature of the penis. The structure of the external genitalia mixed.

Urination is possible in a seated position. In these cases, the diagnosis is genetic testing, is necessary to consult an endocrinologist.

In some cases, a birth defect is only a short length of the MC and its external opening is normally placed. This form of the disease known as "hypospadias without hypospadias."

In this form also revealed deformity of the penis, a cause of which is not only underdeveloped urethra but also to the presence of dysplasia skin connective tissue strand along MC.

Diagnostics

The diagnosis is usually put in the maternity ward after examining the baby. In severe malformations it is important to determine the sex of the newborn. True Hermaphroditism characterized by the presence and ovaries, and testicles.

Female pseudohermaphroditism seen a sharp increase in the girl's clitoris. Sometimes he has a foreskin, which passes on the labia. The vagina is normal, there labia.

In the case of female hypospadias labia are practically absent, underdeveloped vagina. The vaginal opening and the outer opening MK covers thick mucosa.

Manifestations of male pseudohermaphroditism are undescended both testicles, hypoplasia of the penis, hypospadias and nezarosshaya scrotum.

Treatment

Hypospadias treated surgically, and preferably at an early age: from 6 months. 1.5-2 years. Surgical treatment is carried out in this age, it will allow the cavernous bodies in the future to develop normally. Otherwise, further abnormal development of the penis will cause violation of the sexual life in the future.

Comparison of the three types of operations

The operation's success depends on the professional level of the surgeon. According to statistics, 90-95% are successful operations.