Does hypospadias affect fertility?

Hypospadias can occur in both men and women. Hypospadias has a greater impact on men, and may affect their normal urination, fertility, and gender expression. Once hypospadias occurs, some inferiority complex may arise due to the abnormality, and it is also accompanied by pain in the urination opening. The male urethra is connected to the penis and scrotum. Abnormalities in the urethra will affect the normal functioning of the reproductive organs, and generally speaking, normal fertility cannot be achieved, but women can generally do so.

What does the male urethra look like?

The male urethra is a tubular structure. The total length of the adult male urethra is about 16-18 cm, which varies depending on the length of the penis. Through it, urine in the bladder and semen from the prostate and seminal vesicle are discharged from the body. The urethra starts at the bottom of the lower end of the bladder and ends at the end of the penis. It passes through the prostate, convex to the pubic symphysis, passes through the urogenital diaphragm, then passes through the corpus cavernosum and penis, and bends backward and downward.

What are the symptoms of hypospadias?

(1) Abnormal position of urethral opening: The opening is anywhere between the proximal end of the normal urethral opening and the perineum, which often causes the urine flow to deviate and spread downward, making it difficult for the patient to urinate while standing and easily wet the clothes;

(2) Penis curvature: the penis bends downward. Clinically, the degree of curvature is divided into grades 0 to 4. Different surgical methods are used for different degrees of curvature.

(3) Abnormal distribution of foreskin: the frenulum is absent, and the entire foreskin moves to the back of the penis, forming a cap-shaped pile;

(4) Some patients with severe hypospadias also suffer from scrotal fissure (the scrotum is split into two parts), penoscrotal malposition (the scrotum is above the penis), etc.

What are the types of hypospadias?

Hypospadias can be divided into the following types based on the location of the abnormal urethral opening: (1) glans type; (2) coronal sulcus type; (3) body type; (4) penoscrotal type (urethral opening is located at the junction of the penis and scrotum); (5) scrotal type; and (6) perineal type.

What are the dangers of hypospadias?

Hypospadias is often accompanied by downward bending of the penis or unbearable pain during erection.

If left uncorrected, children with severe hypospadias may need to sit or squat to urinate and may avoid intimate contact with the opposite sex due to fear of sexual intercourse.

Severe hypospadias will make it impossible to have a normal sexual life and affect fertility.

What are the characteristics of female hypospadias?

The urethral opening of female hypospadias is on the dorsal wall of the vagina inside the hymen, and most of them are clinically asymptomatic. If the opening is located higher (such as at the neck of the bladder), it is often accompanied by urinary incontinence and requires bladder sphincter and urethroplasty treatment.

What is the cause of hypospadias?

The 9th to 12th week of pregnancy is a critical period for penis formation. During this period, estrogen can promote the formation of the fetal urethra and foreskin. Hypospadias may be related to abnormal maternal hormone levels during this period. Recent studies have shown that possible causes of hypospadias include:

(1) It may be related to genetic factors. Hypospadias has a certain family tendency.

(2) Related to gonadotropin deficiency;

(3) May be related to environmental pollution;

(4) The use of pregnancy-promoting or pregnancy-preserving hormones by the mother before or during pregnancy may also affect the development of the fetus' reproductive system.

What are the current treatments for hypospadias? Which children need surgical treatment?

Surgery is the only treatment for hypospadias. Except for a very small number of cases where the urethral opening is located at the head of the vagina and there is no obvious abnormality in the appearance of the penis, glans penis and foreskin distribution, all other cases of hypospadias require surgical treatment.

When is the best time to undergo surgical treatment for hypospadias?

Hypospadias should generally be completed before school age, and it is recommended to be completed within 8 to 18 months. The penis develops very quickly in the first 8 months, and the penis development tends to be stable after 18 months. In addition, after 8 months, the child's tolerance to anesthesia is significantly improved. In addition, the child's memory is not strong at this time, and the surgery has little impact on his psychological development. If the penis looks normal, there will be no major obstacles to future sexual behavior.