Liu Qi,Shan Zhenchao,Liang Renzhang,et al.Clinical features and pathogenic risk factors of hypospadias in children[J].Journal of Clinical Pediatric Surgery,,18():854-858.[doi:10.3969/j.issn.1671-6353.2019.10.011]
Clinical features and pathogenic risk factors of hypospadias in children
- Keywords:
- Hypospadias; Disease Attributes; Risk Factors
- CLC:
- R726.9;R695
- Abstract:
- Objective To understand the composition profile of children with hypospadias and explore the pathogenic risk factors of hypospadias so as to provide rationales for its etiological researches and early intervention and treatment of high-risk groups.Methods From January 2004 to June 2018,clinical data were retrospectively analyzed.There were 481 cases of congenital hypospadias without complication and during the same period 500 hospitalized cases of congenital hypospadias were surveyed through their parents.Results The admission age was (3.75±2.78).There were 297 cases (43.55%) in cities,towns and villages and 385 cases (56.45%) in rural areas.There were penile glans (n=20,2.93%),coronary sulcus (n=119,17.45%),penile corpus (n=316,46.33%),penile scrotum (n=190,27.86%),scrotal type (n=30,4.40%) and perineal type (n=7,1.03%).There were simple hypospadias (n=481,70.53%) and other malformations (n=210,29.47%).The number of deformity was single (n=180,89.55%),double (n=15,7.46%) and triple (n=3,2.99%).There were urogenital malformation (n=170,84.58%),cryptorchidism (n=150,88.24%),cardiovascular malformation (n=21,10.45%),musculoskeletal malformation (n=5,2.49%) and other malformations (n=9,4.48%).Premature birth (OR=10.60),low birth weight (OR=3.94),maternal hypertension during pregnancy (OR=10.15),maternal dietary fish deficiency during pregnancy (OR=2.53) and paternal exposure to chemical pollutants (OR=2.79) were risk factors for hypospadias.Conclusion Among children with congenital hypospadias,penile corpus is the most common and few are complicated with congenital genitourinary malformations,especially cryptorchidism.Premature birth,low birth weight,hypertension during pregnancy,maternal dietary fish deficiency during pregnancy and chemical contamination during paternal daily life are the risk factors for hypospadias.
References:
1 Ságodi L,Kiss A,Kiss-Tóth E,et al.Prevalence and possible causes of hypospadias[J].Orv Hetil,2014,155(25):978-985.DOI:10.1556/OH,2014,155(25):978-985.
2 Bouty A,Ayers KL,Pask A,et al.The genetic and environmental factors underlying hypospadias[J].Sex Dev,2015,9(5):239-259.DOI:10.1159/000441988.
3 SpringerA,van den Heijkant M,Baumann S.Worldwide prevalence of hypospadias[J].J Pediatr Urol,2016,12(3):151-152.DOI:10.1016/j.jpurol.2015.12.002.
4 徐国顺.尿道下裂发病危险因素的病例对照研究[D].西安:第四军医大学,2017. Xu GS.Case-control study on risk factors of hypospadias[D].Xi’an:Fourth Military Medical University,2017.
5 Schneuer FJ,Holland AJ,Pereira G,et al.Prevalence,repairs and complications of hypospadias:an Australian population-based study[J].Arch Dis Child,2015,100(11):1038-1043.DOI:10.1136/archdischild-2015-308809.
6 Dave S,Liu K,Clark R,et al.A retrospective population-based cohort study to evaluate the impact of an older sibling with undescended testis and hypospadias on the known maternal and fetal risk factors for undescended testis and hypospadias in Ontario,Canada,1997-2007[J].J Pediatr Urol,2019,15(1):1-41.DOI:10.1016/j.jpurol.2018.09.021.
7 Mavrogenis S,Urban R,Czeizel AE.Pregnancy complications in the mothers who delivered boys with isolated hypospadias-a population-based case-control study[J].J Matern-Fetal Neonatal Med,2015,28(4):489-493.DOI:10.3109/14767058.2014.921902.
8 Massaro PA,Maclellan DL,Anderson PA,et al.Does Intracytoplasmic sperm injection pose an increased risk of genitourinary congenital malformations in offspring compared to in vitro fertilization? a systematic review and meta-analysis[J].J Urol,2015,193(5):1837-1842.DOI:10.1016/j.juro.2014.10.113.
9 Aviles LA,Alvelo-Maldonado L,Padro-Mojica I,et al.Risk factors,prevalence trend and clustering of hypospadias cases in Puerto Rico[J].J Pediatr Urol,2014,10(6):1076-1082.
10 George M,Schneuer FJ,Jamieson SE.Genetic and environmental factors in the aetiology of hypospadias[J].Pediatr Surg Int,2015,31(6):519-527.DOI:10.1007/s00383-015-3686-z.
11 Andersen AB,Ehrenstein V,Erichsen R,et al.Maternal inflammatory bowel disease and hypospadias in male offspring:a population-based study in Denmark[J].BMJ Open Gastroenterol,2016,3(1):10.
12 HarauxE,Braun K,Buisson P,et al.Maternal exposure to domestic hair cosmetics and occupational endocrine disruptors is associated with a higher risk of hypospadias in the offspring[J].Int J Environ Res Public Health,2016,14(1):10.
13 Van Gelder M,Van Bennekom CM,Louik C,et al.Maternal hypertensive disorders,antihypertensive medication use,and the risk of birth defects:a case-control study[J].BJOG,2015,122(7):1002-1009.DOI:10.1111/1471-0528.13138.
14 Agopian AJ,Hoang TT,Mitchell LE,et al.Maternal hypertension and risk for hypospadias in offspring[J].Am J Med Genet A,2016,170(12):3125-3132.DOI:10.1002/ajmg.a.37947.
15 Kalfa N,Paris F,Philibert P,et al.Is hypospadias associated with prenatal exposure to endocrine disruptors? A French collaborative controlled study of a cohort of 300 consecutive children without genetic defect[J].Eur Urol,2015,68(6):1023-1030.DOI:10.1016/j.eururo.2015.05.008.
Memo
收稿日期:2019-01-05。
基金项目:宁夏医科大学校级科研项目（编号：XM2015085）
通讯作者:单振潮,Email:18809583332@163.com