Hypospadias and epispadias
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Hypospadias and epispadias
Pathology
Female reproductive system disorders
Amenorrhea
Breast cancer
Fibrocystic breast changes
Intraductal papilloma
Mastitis
Paget disease of the breast
Phyllodes tumor
Intrauterine growth restriction
Oligohydramnios
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Potter sequence
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Pelvic inflammatory disease
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Premature ovarian failure
Sex cord-gonadal stromal tumor
Surface epithelial-stromal tumor
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Congenital cytomegalovirus (NORD)
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Neonatal conjunctivitis
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Cervical incompetence
Gestational diabetes
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Hyperemesis gravidarum
Placenta accreta
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Female sexual interest and arousal disorder
Genito-pelvic pain and penetration disorder
Orgasmic dysfunction
Fetal alcohol syndrome
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Delayed puberty
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5-alpha-reductase deficiency
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Kallmann syndrome
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Bladder exstrophy
Hypospadias and epispadias
Penile cancer
Priapism
Benign prostatic hyperplasia
Prostate cancer
Prostatitis
Erectile dysfunction
Male hypoactive sexual desire disorder
Cryptorchidism
Epididymitis
Inguinal hernia
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Reproductive system pathology review
Benign breast conditions: Pathology review
Breast cancer: Pathology review
Cervical cancer: Pathology review
Complications during pregnancy: Pathology review
Congenital TORCH infections: Pathology review
Disorders of sex chromosomes: Pathology review
Disorders of sexual development and sex hormones: Pathology review
HIV and AIDS: Pathology review
Ovarian cysts and tumors: Pathology review
Penile conditions: Pathology review
Prostate disorders and cancer: Pathology review
Sexually transmitted infections: Vaginitis and cervicitis: Pathology review
Sexually transmitted infections: Warts and ulcers: Pathology review
Testicular and scrotal conditions: Pathology review
Testicular tumors: Pathology review
Uterine disorders: Pathology review
Vaginal and vulvar disorders: Pathology review
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Hypospadias and epispadias
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Epispadias p. 647
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With hypospadias and epispadias, the prefix -hypo means below, - epi means above, and the suffix -spadias refers to a slit or opening.
So instead of having an opening at the tip of the urethra, hypospadias refers to an abnormal opening on the bottom of the urethra and epispadias refers to an abnormal opening on the top of the urethra, and both of these can happen in boys and girls, but are way, way more common in boys.
During genital development in the fetus, there's a point in the 8th week of gestation, when both boys and girls have a similar bit of tissue called the genital tubercle which normally grows in the cranial direction, meaning that it grows towards the head.
After that point, in boys, the genital tubercle responds to the hormone dihydrotestosterone and stretches out a bit into a primitive phallus.
As it grows in length, an area of tissue on the underside called the urethral plate invaginates to form a urethral groove which is lined with epithelial cells.
In the 14th week of gestation, the two urethral folds on the sides pinch off the groove to make it close, and form the penile urethra.
In the 17th week of gestation, the ectodermal cells of the glans penis or head of the penis also undergo a process of canalization, and the urethral canal connects with the penile canal, and that means that the urethra eventually meets the outside world at the tip of the penis.
In a boy, hypospadias happens when the urethral folds along the penile urethra don’t meet up and close properly.
And that leaves an opening somewhere along the bottom of the penile shaft and urine can leak out at that spot, instead of going out the tip of the penis like it should.
Sources
- "Robbins Basic Pathology" Elsevier (2017)
- "Harrison's Principles of Internal Medicine, Twentieth Edition (Vol.1 & Vol.2)" McGraw-Hill Education / Medical (2018)
- "Pathophysiology of Disease: An Introduction to Clinical Medicine 8E" McGraw-Hill Education / Medical (2018)
- "CURRENT Medical Diagnosis and Treatment 2020" McGraw-Hill Education / Medical (2019)
- "A standardized classification of hypospadias" Journal of Pediatric Urology (2012)
- "FEMALE EPISPADIAS" Journal of Urology (1997)
- "Prior Circumcision Does Not Complicate Repair of Hypospadias With an Intact Prepuce" Journal of Urology (2006)
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