The incidence of hypospadias which was reported to be about 1:250 male births has increased over the last years to around 1:150 male births. Some of this rise effect may be due to awareness and better reporting of the condition.

There is however a trend emerging of an increase in the severity of the cases. Hypospadias usually occurs in isolation but occasionally there are other congenital defects. About 15% of major hypospadias cases have other birth defects.

The most common associated defects are undescended testes and inguinal hernias. Hypospadias was commonly thought to occur at higher frequency amongst populations in Europe. It is now however recognised as being as prevalent amongst African populations as well.

Prevalence of Hypospadias in European Countries: Is It Increasing?

Paolo Caione *Division of Paediatric Urology, Department of Nephrology and Urology, ‘‘Bambino Gesu ’’ Children’s Hospital, Piazza S. Onofrio, 4,00165 Rome, Italy

Hypospadias is one of the most common congenital anomalies, the treatment of which is both appealing and challenging for any experienced paediatric urologist. The hypospadiac malformation can be defined as a consequence of a misdevelopment of the urethral spongiosum tissue, with a defect of the ventral aspect of the prepuce and the skin of the distal shaft. Usually, an arrest in the normal embryologic correction of penile curvature is associated, although in a range of different degrees [1,2].

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Prevalence of Hypospadias in Danish Boys: A Longitudinal Study, 1977–2005

Lars Lund a,*, Malene C. Engebjerg b, Lars Pedersen b, Vera Ehrenstein b, Mette Nørgaard b, Henrik Toft Sørensen b,c
a) Department of Urology, Viborg Hospital, 8800 Viborg, Denmark.
b) Department of Clinical Epidemiology, Aarhus University Hospital, 8000 Aarhus C, Denmark.
c) Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA.

ABSTRACT
Background: Hypospadias is a relatively common congenital malformation. Data on temporal trends in prevalence of hypospadias are conflicting. It is unclear whether changes of maternal age distribution over time are associated with changes in hypospadias prevalence.
Objective: To study changes in prevalence of hypospadias in Denmark during a 29-yr period and to investigate whether maternal age was associated with the prevalence of hypospadias. Design, setting, and participants: Through Denmark’s National Patient Registry, covering all Danish hospitals, we identified all boys diagnosed with hypospadias in Denmark. From the Danish Medical Birth Registry, we obtained information on maternal age and on the annual total number of live-born boys from 1977 to 2005.
Measurements: Prevalence of hypospadias at birth.
Results and limitations: Among 921 745 boys born alive from 1977 to 2005, we identified 3490 boys with hypospadias. The prevalence increased from 0.24% in 1977 to 0.52% in 2005, corresponding with an annual increase in prevalence of 2.40% (95% confidence interval: 1.94–2.86). The prevalence of hypospadias did not differ according to maternal age. The mean annual prevalence was 0.38% in sons of mothers aged 25 yr, 0.37% in sons of mothers aged 26–30 yr, 0.39% in sons of mothers aged 31–35 yr, and 0.39% in sons of mothers 35 yr.
Conclusions: The hypospadias prevalence was increasing in Denmark from 1977 to 2005. Increased maternal age did not explain this trend.

2009 European Association of Urology. Published by Elsevier B.V. All rights reserved. Corresponding author. Department of Urology, Viborg Hospital, DK-8800 Viborg, Denmark. Tel. +45 8927 2345; Fax: +45 8927 3481.

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