human health

Hypospadias - Causes and Symptoms

Related articles: Hypospadias

Definition

Hypospadias is a congenital malformation of the urogenital system, due to incomplete development of the urethra and penis during the embryonic life.

This condition derives, in particular, from the incomplete fusion of the urethral folds and / or the failure to channel the solid epithelial cord of the glans. From this it follows an anomalous localization of the urethral meatus, which results in a ventral and proximal position with respect to the apex of the glans.

The urethral meatus is the opening from which urine comes out during urination; therefore, in the presence of hypospadias, urine does not escape from the apex of the penis, but at another point of its ventral surface.

Hypospadias may be associated with cryptorchidism and other abnormalities of the urogenital tract.

Different genetic and environmental factors may contribute to determining hypospadias.

Within some families, mutations have been found in genes implicated in the development of male external genitalia, including those involved in the defects of synthesis, action or peripheral conversion of testosterone by inhibition of androgen receptors.

Hypospadias may also depend on various endocrine mechanisms. The development of the external genitalia in the male is under the control of the sex steroids produced by the testes of the fetus, which is, in turn, influenced by the pituitary and the placenta. Therefore, hypospadias can result from alterations in the production, action or balance of fetus hormones and / or interaction with maternal ones.

The use of substances with hormonal activity taken for contraceptive purposes during the first trimester of pregnancy has been related to a higher risk of hypospadias. The risk also increases in young primiparas and in women over the age of 35.

The arrest of embryonic differentiation in the male sense can be the consequence of vitamin deficiencies in pregnancy, some viral diseases and hypoxic fetal suffering.

Some hypospadias have a toxic origin and depend on exposure to agents that interfere with the maintenance of homeostasis and the regulation of fetal development processes (such as organochlorine pesticides and dioxin).

Also the use of some antiepileptics, such as valproic acid, is associated with the alteration of the normal masculinization of the genitals.

Hypospadias is an extremely rare occurrence in girls; in this case, the urethra opens into the vaginal wall.

Possible Causes * of Hypospadias

  • Achondroplasia
  • Male hypogonadism
  • Pre-eclampsia
  • Rubella
  • Feto-alcohol syndrome