title: Developmental anomalies and disabilities associated with hypospadias.
abstract: OBJECTIVE
  The incidence of developmental anomalies and disabilities associated with hypospadias is still a matter of controversy and data on this issue are sparse. We describe our experience with and evaluation of developmental anomalies and disabilities in a population in which posterior hypospadias was the most common anomaly.
  
  
  METHODS
  We reviewed the records of 356 patients who underwent hypospadias repair from January 1986 through April 2000. Collected data included the Barcat classification of the hypospadias anomaly, anatomical penile variants, associated urogenital and extra-urogenital anomalies, and associated disabilities of physical and mental development.
  
  
  RESULTS
  Of the 356 patients 234 (65.7%) had posterior, 88 (24.7%) anterior and 34 (9.6%) mid hypospadias. Anatomical variants, including penoscrotal transposition, bifid scrotum and micropenis, occurred predominantly in patients with posterior hypospadias, while penile torsion was present exclusively in the other 2 groups. Inguinal hernia, which was the most common urogenital anomaly, was distributed evenly among the 3 groups with a prevalence rate of 12.4%. Undescended testis in 26 cases (7.3%) was most often associated with posterior hypospadias. In order of frequency associated extra-urogenital anomalies included congenital heart disease in 19 cases (5.3%), musculoskeletal anomalies in 11 (3.1%), anorectal malformation in 6 (1.7%), cleft palate in 3 and other in 7. In 21 patients (5.9%) associated disorders were related to physical and mental development, including growth retardation in 6, cerebral palsy in 2 and psychological disorders that significantly impaired patient bodily function, behavior and performance in 11. Most extra-urogenital anomalies or disorders were associated with posterior hypospadias.
  
  
  CONCLUSIONS
  Posterior hypospadias was the most common anomaly in this study. It was associated with a high rate of extra urogenital anomalies, and physical and psychosocial disabilities. The significance of the latter findings with respect to the development of affected patients needs further clarification.
authors.affiliation: Department of Pediatric Surgery, Division of Pediatric General Surgery, Chang Gung Children's Hospital at Kaohsiung, Niao-Sung Hsiang, Koahsiung Hsien, Taiwan, Republic of China.
authors.forename: Wang-Hseng
authors.initials: WH
authors.lastname: Wu
authors.forename: Jiin-Haur
authors.initials: JH
authors.lastname: Chuang
authors.forename: Ya-Chuan
authors.initials: YC
authors.lastname: Ting
authors.forename: Shin-Ye
authors.initials: SY
authors.lastname: Lee
authors.forename: Chih-Sung
authors.initials: CS
authors.lastname: Hsieh
mesh_terms: D000015:Abnormalities, Multiple / Q000453:epidemiology*; D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D002681:China; D015897:Comorbidity; D003430:Cross-Sectional Studies; D002658:Developmental Disabilities / Q000453:epidemiology*; D006801:Humans; D007021:Hypospadias / Q000453:epidemiology*; D007223:Infant; D008297:Male; D012189:Retrospective Studies