title: [Questions and dilemmas in the management of hypospadias].
abstract: Hypospadias is the second most common congenital malformation in males. Etiology remains unknown in about 70% of the cases. Distal hypospadias is considered not only developmental abnormality of the urethra in males, but it may also constitute a mild form of sexual development disorder in 46,XY males. Most urologists and endocrinologists consider that it is necessary to perform a detailed investigation of children presenting with proximal hypospadias associated with a small phallus or poorly developed scrotum and undescended testes. Currently, there is no generally accepted recommendation for the preoperative evaluation of hypospadias and, therefore, masculinizing surgery without preoperative evaluation is performed in these children. The authors summarize the international literature data and their own experience for the assessment and management of hypospadias concerning questions and problems related to preoperative investigation, masculinizing surgery and additional surgery. A detailed algorithm is presented for preoperative evaluation of both proximal and distal hypospadias.
authors.affiliation: Miskolci Egyetem, Egészségügyi Kar Preventív Egészségtudományi Tanszék Miskolc Egyetemváros u. 1. 3515.
authors.forename: László
authors.initials: L
authors.lastname: Ságodi
authors.affiliation: Borsod-Abaúj-Zemplén Megyei Kórház és Egyetemi Oktató Kórház Gyermeksebészeti Osztály Miskolc.
authors.forename: Ákos
authors.initials: Á
authors.lastname: Kiss
authors.affiliation: Miskolci Egyetem, Egészségügyi Kar Preventív Egészségtudományi Tanszék Miskolc Egyetemváros u. 1. 3515.
authors.forename: Emőke
authors.initials: E
authors.lastname: Kiss-Tóth
authors.affiliation: Miskolci Egyetem, Egészségügyi Kar Elméleti Egészségtudományi Tanszék Miskolc Borsod-Abaúj-Zemplén Megyei Kórház és Egyetemi Oktató Kórház Csecsemő- és Gyermekosztály Miskolc Debreceni Egyetem Klinikai Központ Gyermekegészségügyi Továbbképző Intézet Miskolc.
authors.forename: László
authors.initials: L
authors.lastname: Barkai
mesh_terms: D000465:Algorithms; D003456:Cryptorchidism / Q000175:diagnosis; D058490:Disorder of Sex Development, 46,XY / Q000150:complications / Q000175:diagnosis / Q000628:therapy; D005260:Female; D005298:Fertility; D006801:Humans; D007021:Hypospadias / Q000145:classification / Q000150:complications / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery*; D007246:Infertility / Q000517:prevention & control; D008297:Male; D012611:Scrotum / Q000002:abnormalities / Q000601:surgery; D012732:Sex Determination Analysis; D013737:Testis / Q000002:abnormalities; D014521:Urethra / Q000002:abnormalities / Q000601:surgery; D013521:Urologic Surgical Procedures, Male / Q000379:methods
keywords: preoperative investigation; preoperatív vizsgálatok; proximal and distal hypospadias; proximális és distalis hypospadiasis; sebészi kezelés; surgical treatment