Hypospadias

• Published in: Paediatrics and child health 2018-05, Vol.28 (5), p.218-221
• Main Authors: Buschel, Helen, Carroll, Daniel
• Format: Article
• Language: English
• Subjects: hypospadias; paediatric surgery; paediatric urology
• ISSN: 1751-7222; 1878-206X
• DOI: 10.1016/j.paed.2018.03.006

Hypospadias is a relatively common abnormality of the external genitalia and the incidence seems to be increasing. Early recognition and appropriate referral to specialist centres allows for parents to be given timely and accurate information, although in general the surgical management of patients does not commence until one year of age. It is vital that assessment of children with hypospadias includes the position of the testes at the time of recognition. When both testes are adequately descended and palpable within a well-developed scrotum, no further investigation is required urgently. However, abnormalities of testicular descent or scrotal development can point to more serious problems and should be investigated urgently. For these children, hypospadias may be a part of a more complex abnormality in sexual differentiation. The operative management of hypospadias is undertaken by specialist surgeons. Results for distal hypospadias are excellent and few patients have long-term complications from surgery. Proximal hypospadias, particularly in association with other syndromes or disorders of sexual development have poorer long-term outcomes. There is no perfect operation for the correction of hypospadias, and long-term data outlining the advantages and disadvantages of different techniques is lacking in the literature.