Hypospadias and Increased Risk for Psychiatric Symptoms in Both Childhood and Adolescence: A Literature Review.

Tingting Jin,Maolei Shen,Haiya Feng,Shankun Zhao,Shixiong Liu,Weizhou Wu,Ya Wang,Xin Li

doi:10.3389/fpsyt.2022.799335

Tingting Jin, Maolei Shen + Show 6 more

Open Access

https://doi.org/10.3389/fpsyt.2022.799335

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Abstract

Hypospadias is one of the most common congenital malformations in boys. Due to abnormal appearance in the penis with abnormal urination and erection, patients with hypospadias were vulnerable to suffering from stress and psychiatric difficulties. The present study aims to summarize all the current evidence of the association between hypospadias and the risk of psychiatric disorders by a comprehensive review. Seventeen clinical studies were identified in the four electronic databases. A total of 953,872 participants were involved, while 15,729 of them were hypospadiac patients and the remaining 938,143 were normal controls. The standard age for surgery for hypospadias ranged from 20.4 months to 21.5 years. Eight out of seventeen (8/17, 47%) included studies explicitly showed that patients with hypospadias had a significantly higher risk of psychosocial disorders (all P < 0.05). Specific types of psychiatric disorders included depression, anxiety, shyness, timidness, isolation, fear of ridicule, attention-deficit hyperactivity, autism spectrum, behavioral/emotional disorders, temper tantrums, emotionality, affective, psychosexual problems, and suicidal tendencies. Based on this review, psychiatric illnesses are frequently detected in hypospadiac patients' childhood, thus proper psychiatric guidance and early interventions from physicians, nurses, and parents may help these children to grow into less affected men.

Highlights

Hypospadias, one of the common diverse urologic anomalies among children, is characterized by a failure of urethral groove closure leading to an opening on the ventral aspect of the penis [1, 2]
The exact etiologies of hypospadias are still unclear, it is believed that genetic factors, endocrine hormones, environmental components contribute to the pathogenesis [5]
The authors compared the differences between the two groups by performing the stratification analysis on the subject age, age at final surgery, penile appearance, the severity of hypospadias, number of operations, and type of surgical procedure, showing that children, adolescents, and adults following hypospadias surgery did not have a higher risk of poor psychosocial functioning as compared to general populations [30]

Summary

Introduction

Hypospadias, one of the common diverse urologic anomalies among children, is characterized by a failure of urethral groove closure leading to an opening on the ventral aspect of the penis [1, 2]. The severity of hypospadias depends on the failure timing of the incomplete fusion of the urethral folds. The urethra opens ventrally anywhere from the glans to as far back as the perineum, while distal hypospadias accounts for the majority of cases [3]. Hypospadias occurs in 2–43 out of 10,000 live male births and exists along a spectrum of severity [4]. The exact etiologies of hypospadias are still unclear, it is believed that genetic factors, endocrine hormones (i.e., androgens), environmental components contribute to the pathogenesis [5]. There is no consensus on the timing of surgery (cognitive factors, risk of anesthesia, surgical considerations, psychological, developmental, and psychosexual considerations). Surgery is recommended between 6 and 18 months of age [6]

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