Trends in the incidence of cryptorchidism and hypospadias, and methodological limitations of registry‐based data

Toppari, Jorma; Kaleva, Marko; Virtanen, Helena E.

doi:10.1111/j.1600-0463.2001.tb05789.x

Cited by 60 publications

(77 citation statements)

References 44 publications

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Section: Discussionmentioning

confidence: 97%

“…Even birth defect registries might not identify milder forms of hypospadias. 1,12 In our analyses, underreporting of hypospadias, resulting in misclassification of case subjects as control subjects, would have had the effect of biasing results toward the null hypothesis.We found a strong positive association between advancing maternal age and risk of hypospadias. Until recently, multiple studies investigating hypospadias did not report an association with maternal age.…”

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confidence: 97%

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Hypospadias in Washington State: Maternal Risk Factors and Prevalence Trends

Porter

Faizan

Grady³

et al. 2005

Pediatrics

101

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ABSTRACT. Objective. Maternal risk factors for hypospadias are poorly defined, and there is debate about temporal trends in hypospadias prevalence. We examined select maternal characteristics as possible risk factors for hypospadias among male offspring and evaluated yearly prevalence rates in Washington State.Methods. We performed a population-based, casecontrol study using linked birth-hospital discharge data from Washington State for 1987-1997 and prevalence data for 1987-2002. All cases of hypospadias were identified on the basis of International Classification of Diseases, Ninth Revision, codes from the birth hospitalization (N ‫؍‬ 2155). Five control subjects were randomly selected for each case subject from the remaining singleton births, frequency matched according to year of birth (N ‫؍‬ 10 775). Maternal and infant characteristics were ascertained from the birth certificate. Logistic regression was used to calculate odds ratios (ORs) and 95% confidence intervals (CIs). Yearly prevalence was determined by dividing the total number of hypospadias cases by the number of male singleton live births for each year.Results. The risk of delivering an affected male infant increased with advancing maternal age; relative to women <20 years of age, those >40 years of age were at greatest risk (OR: 1.70; 95% CI: 1.17-2.48). Infants of nonwhite women were generally at decreased risk. Infants born to women with preexisting diabetes mellitus were at greater risk than those born to women without diabetes (OR: 2.18; 95% CI: 1.03-4.60); however, this was not observed for infants born to women with gestational diabetes. The birth prevalence of hypospadias in 2002 was 5.0 cases per 1000 male births, not significantly different from that in 1987.Conclusion. Older maternal age, white race, and preexisting diabetes were associated with increased risk of hypospadias among male offspring. H ypospadias is one of the most common congenital anomalies in the United States, with an estimated prevalence of 3 to 8 cases per 1000 male births. 1,2 The malformation is the result of incomplete fusion of the urethral folds, which usually occurs between 9 and 12 weeks of gestation. Although the success rate for surgical repair is high, 3 the high prevalence of hypospadias translates into a significant financial burden on the health care system. When rare complications do occur, the resultant morbidity of corrective procedures, psychologic stress, and potential loss of function can be devastating to the patient and family.Although hypospadias is common, risk factors for this birth defect are relatively poorly defined. Familial aggregation is well recognized. 4 It has been established that low birth weight and shorter gestation are associated with hypospadias, 5-7 but other risk factors are more controversial. At least 2 studies have suggested that older maternal age may be a risk factor for hypospadias, 1,8 but both of those studies relied on data from the same birth defects registry. Studies that examined race as a potential risk factor have...

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Section: Discussionmentioning

confidence: 97%

mentioning

confidence: 97%

Hypospadias in Washington State: Maternal Risk Factors and Prevalence Trends

Porter

Faizan

Grady³

et al. 2005

Pediatrics

101

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“…Consequently, it is being speculated that male reproductive anomalies (hypospadias, cryptorchidism) [97,98] and the global fall in sperm counts [1] have both a causal link in the marked increased of phytoestrogens in our diet brought about by the western adoption of a fast food culture [99,100].…”

Section: Xenoestrogensmentioning

confidence: 99%

Occupational and Lifestyle Exposures on Male Infertility: A Mini Review

Ten¹,

Mendiola²,

Torres-Cantero³

et al. 2008

TORSJ

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Human semen quality may be declining due to environmental pollutants, occupational exposures or changes in lifestyle. Nonetheless, we still know little about the impact of those factors on male fertility. Some heavy metals, volatile organic compounds or xenoestrogens may compromise reproductive male function. This process could take place along the human life cycle and not only in certain stages of development. We review the main factors that affect human male fertility and their possible influence in current human reproduction.

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“…3 The second and third characteristics are not present in all cases. Hypospadias causes not only functional problems but also psychological problems for patients and their parents.…”

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confidence: 97%

Does the early removal of urethral stent can reduce postoperative complications of Snodgrass urethroplasty for hypospadias repair? A prospective randomized trial

2017

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Background: Hypospadias is a relatively common congenital defect of the male external genitalia. The objective of this study was to evaluate whether the early removal of urethral stent following TIP Snodgrass repair of hypospadias can reduces postoperative complications of this procedure.Methods: In Al-Yarmouk teaching hospital, the surgical procedure included 61 tabularized incised plate (TIP) repairs for penile hypospadias. The patients were prospectively observed over 36 months and randomized into 2 groups, group (A) was 30 patients where the urethral stent was removed after 24 hours of operation, and group (B) was 31 cases where the stent removed in the 6th postoperative day. Suprapubic urinary diversion was done for all patients. All of the operations were performed by the same surgeon. Complications and cosmetic appearance were documented at last follow-up.Results: The average age of the patients was 3.9 years, urethrocutaneous fistula was observed in 2 cases in group A (6.6 %), while 11 patients had fistula in group B (35.4 %) with a statistically significant difference (p < 0.05). meatal stenosis was reported in 4 patients in (group A) (13.3%), while 12 patients had such complication in group B (38.7%) with a statistically Significant difference as (P< 0.05). 6.6 % of group A developed wound infection, while 32.2 % had wound infection postoperatively in group B with a statistically significant difference (P< 0.05). Complete surgical failure when wound dehiscence occurs, it was found that no significant difference between the 2 groups (P value=0.1).Conclusions: TIP repair is a versatile operation that can be performed in almost all cases of penile hypospadias. We believe that early stent removal after 1 day of surgery for hypospadias repair simplifies postoperative care, highly reduces risk of development of urethrocutaneous fistula, meatal stenosis and wound infection, so obviates the need for antibiotics.

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Trends in the incidence of cryptorchidism and hypospadias, and methodological limitations of registry‐based data

Cited by 60 publications

References 44 publications

Hypospadias in Washington State: Maternal Risk Factors and Prevalence Trends

Hypospadias in Washington State: Maternal Risk Factors and Prevalence Trends

Occupational and Lifestyle Exposures on Male Infertility: A Mini Review

Does the early removal of urethral stent can reduce postoperative complications of Snodgrass urethroplasty for hypospadias repair? A prospective randomized trial

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