Frequently Asked Questions
The following information is reproduced with grateful acknowledgement to the Hypospadias and Epispadias Association (HEA) in the USA.
What are hypospadias and epispadias?
What problems do hypospadias and epispadias cause?
How do I know whether the condition is mild or severe?
Hypospadias and epispadias are also often associated with severe curvature of the penis, or chordee, especially in more severe cases. Epispadias may also be associated with a severe condition known as bladder exstrophy, in which the bladder forms outside of the abdominal cavity.
Will boys with hypospadias/epispadias be able to father children when they grow up?
How common are hypospadias and epispadias?
What causes hypospadias/epispadias?
However, male hormones (testosterone and dihydrotestosterone, or DHT) secreted by the male embryo beginning around 10 weeks of development alter the default developmental pathway. The male hormones cause the genital swelling to create the scrotum, the genital folds to fuse together to become the shaft of the penis, and the genital tubercle to form the glans or tip of the penis.
Normally, in male development, the genital folds fuse completely so that the penis completely surrounds the urethra all the way to the tip. Hypospadias/epispadias results when the genital folds fail to fuse properly, leaving part of the penis open and the urethra incompletely developed.
No clear underlying cause of the incomplete fusion has been identified, and there are likely many contributing factors which act together to cause the condition.
- Studies indicate that genes play a role; however, men with hypospadias or epispadias will not necessarily father children with the condition.
- Environmental pollutants that resemble female hormones (oestrogens) or interfere with male hormones may also play a role, but the studies were performed in animals and may not be relevant to humans.
- Some medications may also contribute. For example, pregnant women are advised not to come in contact with the baldness medication Propecia, which blocks formation of DHT, because it may increase the incidence of hypospadias.
The information below is reproduced with grateful acknowledgement from the Bladder Exstrophy Family Association website in Manchester, United Kingdom.