Hypospadias is a urethral opening proximal to the normal anatomic orifice and located on the ventral surface (underside) of the male genitalia in the midline. It is causes by a failure of mesodermal urethral folds to converge in the midline.
Group
Location of Opening
Frequency (Duckett)
anterior (first degree)
(1) glandular
(2) subcoronal
50%
middle (second degree)
(3) distal
(4) midshaft
(5) proximal
30%
posterior (third degree)
(6) penoscrotal
(7) scrotal
(8) perineal
20%
Chordee is a ventral curvature of the penile shaft. It may result from either (a) failure of the urethral plate to disintegrate or (b) fibrosis of inner genital folds. The angle of the deviation can be measured, with < 30° considered mild and > 30° more severe.
Associated findings:
(1) ventral defect in foreskin
(2) undescended testes (cryptorchid)
(3) intersex state
(4) inguinal hernia
(5) upper urinary tract anomalies
(6) imperforate anus
(7) meningomyelocele
(8) urethral defects (short or hypoplastic)
(9) prostatic utricle
(10) variable endocrine abnormalities
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