Hermaphroditism Hypospadias

Hypospadias is a relatively common congenital defect, which refers to the abnormal position of the male urethral opening. There are many causes of this deformity. The most common one is that the pregnant mother has some bad habits, which causes this condition in the child. This is relatively harmful to the child's future life. If it is more serious, it may even have a greater impact on the marriage life. Therefore, in this case, surgical treatment must be carried out in time.

The cause of hypospadias is that the penile fascia and skin fail to develop normally on the ventral side of the penis during the 8th to 14th week of pregnancy. Hypospadias may form when the urethral groove is not fully fused. At the same time, the corpus spongiosum is also incompletely developed, forming a cord-like shape at the distal end of the hypospadias, which can cause penile curvature. Most cases of hypospadias have no clear cause, and most scholars believe that multiple factors are involved in the formation of hypospadias. A small number of cases may be caused by single gene mutations, while most cases reported in the literature are related to advanced maternal age, endocrine levels, ovulation-inducing drugs, anti-epileptic drugs, low birth weight, preeclampsia and other environmental factors.

Clinical manifestations (I) Hypospadias may have the following manifestations : 1. Ectopic urethral orifice The urethral orifice may appear in any part of the urethra from the proximal end of the normal urethral orifice to the perineum. 2. Curvature of the penis means that the penis bends toward the ventral side, which makes it impossible to urinate and have sexual intercourse normally. The causes of penile curvature include incomplete development of the ventral side of the penis and axial shortening of the tissue. 3. Abnormal distribution of foreskin: The foreskin on the ventral side of the glans penis fails to fuse in the midline, so it presents a V-shaped defect, the frenulum of the foreskin is absent, and the entire foreskin is turned to the dorsal side of the glans penis and piled up in a cap-like shape. 4. Splashing of urine during urination.

(II) Hypospadias can be divided into four types according to the anatomical location of the urethral opening : 1. The glans-type urethral opening is located on the ventral side of the coronal sulcus, mostly in the shape of a slit, usually only accompanied by mild penile curvature, which usually does not affect sexual life and fertility; 2. The phallic-type urethral opening is located on the ventral side of the penis from the coronal sulcus to the junction of the scrotum and penis, accompanied by penile curvature; 3. The scrotal-type urethral opening is located in the scrotum, often accompanied by scrotal splitting and severe penile curvature; 4. The perineal-type urethral opening is located in the perineum, with scrotal splitting, underdeveloped, short and curved penis, and is often misdiagnosed as female. Since the external urethral opening will retract toward the perineum to varying degrees after the curvature of the penis is corrected, the method of classification based on the retracted position of the urethral opening after correction of the curvature of the penis has been accepted by many doctors in recent years. Children with severe hypospadias often have other associated malformations, including cryptorchidism, inguinal hernia, hydrocele, prostatic sac, penoscrotal transposition, penile torsion, micropenis, duplicated urethra, etc. A small number of patients may have combined anorectal malformations.

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