What causes hypospadias?
To the surprise of many who until this point have never heard of hypospadias, hypospadias is one of the most common congenital malformations. It is considered to be a mild form of the 46,XY disorders of sex development, but its exact etiology remains unclear.
Compromised androgen synthesis can cause hypospadias, although this is found in a minority of cases. The majority of hypospadias cases are chalked up to genetic and environmental causes.
So, what causes hypospadias?
The exact causes of hypospadias is unknown. We do know that the penis forms between the 9th and 12th week of pregnancy – before that the male and female genitalia are similar. Problems during this period, and even up to the 20th week, may disrupt normal develop of the penis and lead to hypospadias.
Increases in hypospadias tend to be localized to regions or periods
We also know that increases in hypospadias tend to be localized to regions or specific periods. For example, there was a 2003 study that found significant elevated incidence of hypospadias in two Southeastern Sicily towns that were selected on the basis of intense industrial and agricultural in that region. In general however, hypospadias is thought to be on the rise in western cultures since the 90s. There is also a family incidence, where 7% of males with hypospadias have fathers and/or brothers with hypospadias, and certain factors can lead to an increased risk of hypospadias, including mothers who are obese, older than 35, or have used fertility treatments such as progesterone or other hormones before or during their pregnancies.
As a mom with a son born with penoscrotal hypospadias, one thing I can share is this: You didn’t cause it and it can be fixed. If his hypospadias is severe enough, schedule surgery when you’re ready and when you’ve found the right surgeon, and move forward.
I did find in our post-surgery talks with Dr. Snodrass, one of the best hypospadias surgeons in the world, that the opinion that if you or your child was born with more proximal hypospadias, he would have to be monitored for life is not necessarily the case. This is more for medical monitoring than it is for you or your child. While I do agree that the monitoring is valuable, as is peace of mind for your family. Plan to have surgery, live your life, and know that the future of hypospadias may have great things on the horizon.