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Questions and Answers
Penile epispadias is located somewhere along the ______
penis
The most severe form of epispadias is ______
penopubic
In girls, estrogens stimulate the development of the external genitalia, leading to the formation of the ______
clitoris
Boys with hypospadias may experience difficulty with ______
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Epispadias in females is often associated with a bifid ______
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Hypospadias and epispadias can lead to sexual dysfunction, infertility, and psychosocial problems if left ______
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In boys, hypospadias can occur near the head of the penis, which is anatomically known as ______
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Hypospadias happens when the urethral folds along the penile urethra don't meet up and close properly, leaving an opening somewhere along the bottom of the penile shaft where urine can leak out instead of going out the tip of the penis like it should. This typically occurs during the genital development of the fetus on the ______ week of gestation.
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During the 14th week of gestation, the two urethral folds on the sides pinch off the groove to make it close and form the ______ urethra.
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In the 17th week of gestation, the ectodermal cells of the glands penis or head of the penis undergo a process of canalization and the urethra canal connects with the penile canal, eventually meeting the outside world at the tip of the penis. This process is crucial for the proper formation of the ______.
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Epispadias is abnormal on the opening above the urethra, and it is common in boys during the genital development of the fetus on the 8th week of gestation. In the case of epispadias, the abnormality is located ______ the opening of the urethra.
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The urethral plate invaginates to form a uterthal groove lined with epithelial cells, which eventually leads to the formation of the ______ urethra when the two urethral folds pinch off the groove during development.
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Study Notes
Abnormalities of Urethral Opening
- Hypospadias: abnormal opening of the urethra on the underside of the penis
- Epispadias: abnormal opening of the urethra on the upper side of the penis
Development of Genitalia
- In the 8th week of gestation, the genital tubercle grows in the same direction for both males and females
- In males, the tubercle responds to dihydrotestosterone and grows in a cranial direction
- In the 14th week of gestation, the urethral folds pinch off the groove to form the penile urethra
- In the 17th week of gestation, the ectodermal cells of the glans penis undergo canalization and connect with the penile urethra
Hypospadias
- Occurs when the urethral folds along the penile urethra don't meet up and close properly
- Leaves an opening along the bottom of the penile shaft, causing urine to leak out
- Anatomically, hypospadias can occur in three areas:
- Glanular (near the head of the penis)
- Midshaft (middle of the penis)
- Penoscrotal (where the penis and scrotum come together)
- Generally, the least severe hypospadias are glandular and the most severe are penoscrotal
Epispadias
- Occurs when the genital tubercle grows in the posterior direction towards the rectal area instead of the cranial direction
- Anatomically, epispadias can occur in three areas:
- Penopubic (where the base of the penis and the abdominal wall come together)
- Penile (somewhere along the penis)
- Glandular (near the head of the penis)
- Generally, the least severe epispadias are glanular and the most severe are penopubic
Hypospadias in Girls
- Hypospadias results in the urethra opening into the anterior vaginal wall
- Symptoms include frequent and painful urination, recurrent urinary tract infections, and sexual dysfunction
Causes and Associations
- Hypospadias and epispadias are thought to be related to fetal exposure to abnormal levels of androgens and estrogens
- Hypospadias is more common and associated with other conditions like:
- Chordee (penis has a hook shape and curves inwardly)
- Inguinal hernia (protrusion of bowel through the inguinal canal)
- Cryptorchidism (absence of testes from the scrotum)
- Epispadias is associated with:
- Bladder exstrophy (bladder sticks out through the abdominal wall)
- In females, bifid clitoris (clitoris is divided into two)
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Description
Learn about the abnormalities of hypospadias and epispadias which occur during the development of the genitalia in fetuses. Understand how these conditions are related to the positioning of the urethral opening in boys and girls during the 8th week of gestation.
