Hypospadias / Epispadias

Introduction

• Embryological malformations of the urethra (urethral groove)
  • may involve the urethral folds or genital tubercle 
• Two main types
  • epispadias
    • urethra opens on dorsal surface of penis
      • urine goes ↑
    • defect in the genital tubercle
  • hypospadias
    • urethra opens on ventral surface of penis
      • urine goes ↓
    • defect in closure of urethral folds 
      • secondary to abnormal androgen production
    • associated with a ventral curvature of the penis (chordee)
    • risk factors
      • monozygotic twins
      • potential association with in-vitro fertilization (IVF)