Talk:Hypospadias

What needs to be established
I removed some unsubstantiated insertions that I think are misleading and incorrect, but am willing to reconsider parts or rephrasing if support can be given. I also consider the removal of one of the universally attested facts about hypospadias -- that they are usually sporadic birth defects of unknown cause to be evidence of bad faith and fringe POV by the editor. Furthermore, a lower opening on the shaft created by surgery is called a fistula not a hypospadias; no one but someone trying to confuse rather than clarify the topic would attempt to conflate the two. But let's hear the support for some of the more obscure claims? alteripse 01:35, 9 Feb 2005 (UTC)

Alas, this was the anti-circumcision advocates at it again, people for whom every article is an opportunity to fit something in about circumcision. Yes, some circumcisions cause unintended damage, even catastrophic damage in some cases (note that I'm not taking a position for or against circumcision here). However, the place to write about that is in the circumcision article, or even the iatrogenesis article, and not this article, which is quite unrelated. -- Karada 12:58, 9 Feb 2005 (UTC)


 * Karada's personal attack aside, one can search for "iatrogenic hypospadias" and all becomes clear. Cetinkaya describes a clear instance .   In non-circumcising cultures, a urethral catheter can also be a cause of the defect (Andrews ), so that might be added too.  A fistula can also be iatrogenically induced, but it is a separate phenomonon.  The AMA site specifically lists hypospadias .  Why is there a knee-jerk motivation to censor iatrogenic sources? DanP 19:08, 9 Feb 2005 (UTC)

DanP, 1. Do NOT accuse me of "kneejerk censorship" of iatrogenic problems. THEY ARE ALREADY DESCRIBED IN THE ARTICLE under the appropriate section, and I explained exactly why I reverted: because you removed important info and replaced it with confusing and erroneous info. A iatrogenic opening in the urethra is nearly always called a fistula, not a hypospadias. 2. According to the AMA citation a 21 year old review mentions circumcision as a possible cause. It is extremely rare, but we can mention it. 2. if you would like to have a sentence that an EXTREMELY rare cause of a fistula, is a urinary catheter, we could probably accommodate that with a reference but your desire to put that into this brief summary confirms exactly what Karada accuses you of-- that you have a bizarre single-minded fringe POV 2. and your removal of valid information (that we have no explanation for the majority of hypospadias and they are sporadic birth defects) is hard for me to understand. Are you trying to make it sound like most hypospadias are iatrogenic? Do you believe that? Why do you want to give us that impression? 3. DONT do unexplained deletions of important information 4. What is the difference between you and Borert Brookes? You complain about him on your user page, but you behave the same way: unexplained reversions, EXTREME singleminded POV while dishonestly denying it, and unwarranted insults to the rest of us. You and he are both a blight here and I am being extremely restrained in my response. I am adding your points. You didn't have to be so offensive to get this added. alteripse 21:45, 9 Feb 2005 (UTC)


 * I apologize for careless mistake - my efforts here are in good faith. Information I deleted was clearly implying that congenital hypospadias is the only variety.  I should have edited more carefully.  The initial response to me was hostile, and you should at least know that I did not throw the first stone.  I am well aware of what a fistula is.  The fact that it is not the term used in cases of iatrogenic hypospadias is remarkable enough of a distinction, and the flow of urine is another distinction.  There are clear cases of iatrogenic hypospadias as I mentioned.  I am not aware of exact percentages, but it is wrong to merely speculate.  If you believe it important to push iatrogenic hypospadias out, I will respect that.  Robert Brookes makes no effort to seek truth or consensus, yet I still respect his perspective no matter how much I am critical of it (I have repeatedly told him this).  I believe that is a valuable distinction to be made before you make your broad claims.  I deny nothing about my disagreement with his view -- I never have denied any such thing.  Any accusations that I make such denials are entirely fabrications.  In the end, the feigned neutrality of some folks leave Wikipedia with the attitude "so be it if the article leaves out facts".  Obviously you have already decided what hypospadias does and does not include.  Yet the circumcision advocates get away with inclusion of material with far less substantiation, whereas iatrogenic hypospadias had been clearly photographed.  While I thank you for explaining my mistake, at the same time I take your accusation of being a "blight" as a personal attack, and as ad hominem by definition.  I have extended the olive branch to the circumcision advocates on several occasions, and there is no need to use name-calling here on either side. DanP 19:36, 10 Feb 2005 (UTC)

Apology accepted, but you still removed twice with no explanation the simple and unarguable statement that the causes of most hypospadias is unknown congenital birth defect and even in the paragraph just above you misrepresent the sentence as saying congenital hypospadias is the only variety. Iatrogenic hypospadias that are results of circumcision are so rare I have never heard of it (which doesn't mean that it hasn't happened sometime somewhere in a single case in the medical literature) and I suspect you have not bothered to look up the citation in the 1983 Urol Clin review article, which I suspect simply mentioned it in a list just like the AMA review does. I have never heard the term hypospadias applied to a iatrogenic opening and still suspect it is a semantic anomaly. I bend over backwards to accommodate valid material in a medical article, if there is a reference, and every article I have written includes complications. It is certainly POV, and not quite honest, to find a single case of a pair of problems caused by an "itinerant Turkish circumciser" and insert here as if medical procedures are a significant cause. I still would like to see you and Robert Brookes locked away together in any number of circumcision articles you two want to fight about so the rest of us can write an encyclopedia without the kind of stuff you just pulled here. alteripse 00:07, 11 Feb 2005 (UTC)

Epispadias
Epispadias is not related to hypospadias, but rather to bladder exstrophy. I was suprised to find that Epispadias redirects to hypospadias. I propose that epispadias should have its own article. A parent whose child has epispadias (a very rare conditions) is not served by looking it up and then wading through hypospadias stuff (especially if their child is female!).Tony Makhlouf


 * Your wish is our command. See epispadias, but it is only a stub at this point. Feel free to add water and make it grow. alteripse 20:45, 24 December 2005 (UTC)

Image
The image was quite large and explicit. Therefore, I have decided to Be Bold and move it below the fold. DrExtreme 01:14, 19 March 2007 (UTC)

Image (again)
The photo of a near-standard, "stimulated" penus should be treated as pornography, especially when a photo of an unstimulated penus from the same or different subject may be shown. If a problem with photographic positioning in showing any anomally is deemed to be the rationale behind such a submission, the penus may be lifted by finger, hand or other non-sexual-intended instrument. The image title "Enlarge" is also indicative of other-than-educational intentions. The display has been removed. 76.107.46.66 06:31, 24 June 2007 (UTC)
 * Wikipedia is not censored. --Core desat 06:38, 24 June 2007 (UTC)


 * sorry, but it is not pornography. This is a medical article. Furthemore, the picture in question is below the page break. Furthmore, it shows a classic example of moderate Type-1 hypospadias, of the sort that can cause both urinary and reproductive issues. Encyclopedic and relevant. There aren't too many articles that require penis images, but this is one of them - A l is o n  ☺ 06:40, 24 June 2007 (UTC)
 * Image has been replaced, BTW - A l is o n  ☺ 06:41, 24 June 2007 (UTC)
 * Alison, I object to removal of the image without first discussing it here. To the point, I am familiar with medical textbooks on the subject, and none have an image of an erect hypospadic penis, simply because the erection does nothing to illustrate the defect. Such an image would have an encyclopedic value only if it would demonstrate the "chordee" (panile curvature) which often coexists with hypospadias. And BTW, coronal hypospadias like the one depicted in the image, is not likely to cause urinary or reproductive issues. IMO the image should be removed not because of moral issues, but because of lack of encyclopedic value.  Derwig 07:04, 24 June 2007 (UTC)
 * Well, yes. I'm familiar with the textbooks too. However, it's still indicative of classic Type 1 and most cases of mild hypospadias present as shown and this article need an illustrative image. Yes, the erection does little to show the defect and appears to be incidental and no chordee is present. To me, that image doesn't look coronal as the urethral opening appears (to me) to be below the glans. How and ever, it might be the time to bring the image to IfD. Anyone care to add it here? - A l is o n  ☺ 07:14, 24 June 2007 (UTC)

Will you people please make this clear, instead of fear of steping on toes for not being politically correct; i had this and want to know why i got the random scar. I was born in 1981, had surgery for it in 1991. and i still have memories/horrors of going in for surgery, as well as recovery.

BTW, anyone have pictures of Type 2, or Type 3? If it is in the article, maybe clarify the article for us medic-lingo challenged please? 76.170.117.217 11:32, 14 August 2007 (UTC)
 * Hi there. What exactly would you like clarified? Is it the concept of the types and how you quantify what type 1,2,3 is? I had it too, and had surgery at 9 years old - I can remember it clearly, too, and the dreadful disinfectant baths I used to have to take after the surgery. Mine would have been type 2 & there's a strong suggestion that my mom took diethylstilbestrol during her pregnancy (I was born in 1967). See here, here and here for more clinical details + images. I also had severe gender identity issues which ultimately became insurmountable & needed .. umm .. "correction". There's usually scarring on the underside of the penis, from the meatus down along the shaft, with stitch marks along - possbly scarring from grafting of the foreskin in severe cases - 24.6.254.162 12:00, 14 August 2007 (UTC)
 * This article describes the condition rather well, as well as showing incisions, stitches, etc -  A l is o n  ☺ 12:30, 14 August 2007 (UTC)

Image (yet again)

I must respectfully disagree with calling the image 'pornography.' First of all, I'd ask who would be looking at this page besides someone who knew of hypospadias. Secondly, does anyone really think there are people googling 'hypospadias' to get their jollies -- as is the apparent utility of porno? Methinks not.

The image makes the condition and its correction and outcome obvious, which I trust was the intent. As one born with the condition in 1960 and having undergone six surgeries to correct it, I am fortunate to have only the horrible, painful memories of that early life experience. It was affirming for me to read how relatively prevalent the condition is, and my hope is that other sufferers of this birth defect will accept themselves as complete and normal human beings. It has taken me a long time to be able to say that.

Hypospadias can be corrected thanks to science and those devoted to its practice; I am always thoughtful of that. And one can, as I have been exceedingly fortunate to, live a normal life (though, yes, with messy stand-up urination... but sitting down is much more relaxing) and parent children, who, by good fortune in our case, do not bear the same physical and emotional scar tissue their dad does. Hypoguy 06:45, 18 August 2007 (UTC)

---As a mom and a woman with some education and professional experience in the medical field, I first thought this image was a piece of garbage. I can tell you that this image has really helped moms who have hypospadias sons. —Preceding unsigned comment added by 66.177.9.220 (talk) 22:26, 20 January 2008 (UTC)

This is not pornography. Having the condition myself, I was very interested in simply comparing. Leave it alone. —Preceding unsigned comment added by 70.232.64.29 (talk) 01:21, 11 March 2009 (UTC)


 * It may not be "pornography", in that it is not particularly arousing. Just because Wiki doesn't censor, and that the picture may be related to the article, doesn't mean it's the right one or the right place for it. Wikipedia is not a medical textbook - and there isn't even agreement on whether this picture fits with the condition. I disagree that there are supposedly "only so many" articles which require pictures of penises, this is not the first one I have seen, nor is it likely to be the last. I happen to read wiki from article to article, going from one topic to another, and I think I should be able to read about various subjects without having to look at somebody's deformed genitals, no offense. If you want to compare yours, find a medical site or a forum for people with your condition. This is a place for study, not consolation. I'm not trying to censor anybody (especially not the producer of the picture in question), and this issue has also been discussed on the masturbation article - but is it so outlandish to suggest that Wikipedia be ONE place on the internet where I'm not confronted with dicks? I just want to read, dammit. MisplacedFate1313 (talk) 01:30, 6 April 2009 (UTC)


 * What are you afraid of boohoo "GENITALS", seriously grow up. Sincerally, C6541 (T↔C)  at 20:35, 19 July 2009 (UTC)

News on the subject
http://www.scientificblogging.com/search/node/hypospadias has some new information on cause and prevention. --213.22.5.71 (talk) 19:31, 21 November 2008 (UTC)

First degree hypospadias...?
The description seems to indicate that the meatus being on the glans is a mild form of hypospadias, and therefore that all "normal" males have hypospadias! having looked into it i have found that the descriptin is not sufficient.

''The urethral meatus opens on the glans penis in about 50–75% of cases; these are categorized as first degree hypospadias. Second degree (when the urethra opens on the shaft), and third degree (when the urethra opens on the perineum) occur in up to 20 and 30% of cases respectively.''

should it be:

''The urethral meatus opens on the underside of the glans penis in about 50–75% of cases; these are categorized as first degree hypospadias. Second degree (when the urethra opens on the shaft), and third degree (when the urethra opens on the perineum) occur in up to 20 and 30% of cases respectively.''

I based this on:

http://www.lucinafoundation.org/birthdefects-hypospadias.html

Thoughts please. Wuku (talk) 20:47, 21 January 2010 (UTC)

Seems like a reasonable correction to me. Eperotao (talk) 16:51, 8 April 2011 (UTC)

EW
I was reading an article about a political figure, with other people in the room, that said he had this. I had no idea what this was so I clicked it. I do not need a giant deformed penis picture on my screen without a warning, thanks Lemniwinks (talk) 20:11, 7 March 2010 (UTC)
 * I agree with you, but we have a number of determined young (or perhaps just immature) young men who throw a tantrum whenever someone removes one of their penis pictures. alteripse (talk) 21:35, 7 March 2010 (UTC)
 * The picture illustrates the condition. The "immature" ones are clearly you, as you seemed to be so bothered about one penis. In context to the page, it is well suited, you should grow up.--86.20.253.33 (talk) 19:41, 4 April 2010 (UTC)
 * QED. alteripse (talk) 16:50, 5 April 2010 (UTC)


 * I kind of disagree about "...it is well suited" this picture comes from an exhibitionist, as a prior version of the german Wikipedia tells us http://de.wikipedia.org/w/index.php?title=Hypospadie&oldid=49847629 There is no way that these three pictures are motivated from medical point of view ;) But in the  absence of a better picture I believe its tolerable 193.175.73.207 (talk) 19:26, 17 May 2010 (UTC)

Frequency of occurrence
The sentence It is the second most common birth abnormality in boys, affecting approximately 1 of every 300. occurs in the introduction, but Hypospadias is among the most common birth defects in the world and is said to be the second most common birth defect in boys, occurring 1 in every 200 births. is the first sentence in the Epidemiology section. How common is this condition? The 1 in 300 reference is a book I don't have access to, so I can't check; the other (http://emedicine.medscape.com/article/1015227-overview#a0199) says approx 1 in 250. UCSF agrees with the emedicine estimate. I'm going to change both to reflect the 1 in 250, so they agree. Wocky (talk) 14:50, 28 July 2015 (UTC)

External links modified
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Medical Intervention
I’ve never edited an article, so I’ll leave it to others, but I am concerned about the lack of language on unnecessary medical intervention on this page. There is no statement anywhere about people deciding not to undergo surgical repair and their quality of life, or the people who had no idea they had this “problem” until much later in life, if ever.

As one article states: “The view of the surgeon about the success of an operation may be totally different from that of the boy or man with hypospadias or his parents. Many urologists and plastic surgeons who perform a large number of these operations appear to take the view that hypospadias surgery should be performed because:

Every man should be able to stand to urinate Every man should be able to have “normal” sexual intercourse with a woman, with the aim of trying for a pregnancy A urine stream that sprays is embarrassing A penis that is bent sideways or downwards is embarrassing A penis head that is shortened and blunted is “deformed”

This page appears to be written from the perspective of the surgeon who hasn’t considered NOT conducting surgery that may be medically unecessary due to personal bias about penis aesthetics. I think a statement about surgical repair being common, but not required or attempted in all cases, is important. Thanks for your time. — Preceding unsigned comment added by 2600:1002:b02c:92dc:a45e:838b:37a8:f2b1 (talk • contribs) 19:31, 23 July 2018 (UTC)

hypospadial correction and human rights
The article does mention (with what I guess is sufficient referencing) that certain groups regard this abnormality in itself as an intersex condition, and that correcting it before the afflicted person cI must state that an consent is a human rights violation. Having been born with this condition, and I suspect a rather extremer form of it, and having had it corrected by surgery before I turned five. I must state that I was afterwards fully raised up as a boy, and as it happens, I now am and older man, with neither mental or physical problems relating to this. If my parents had waited for me to be older (or if I had had to wait till I turned 18 to consent), I would very likely have had many more problems than I actually had, and don't feel at all my rights were violated. This may not be the case for actual intersex persons with the condition, but given the rather common status of it, I assume that many more ordinary boys are born with it than intersex people. Ergo, there should be better qualification before corrective surgery is regarded as a wrong. Svartalf (talk) 23:12, 13 December 2022 (UTC)

female hypospadias
i think this article should probably have a section on female hypospadias, it's a lot less common than the male version but i think it's worth a mention. not sure how to go about it myself so i'm leaving this here for further discussion and/or inspiration, lol Eatingbugs (talk) 22:50, 5 April 2024 (UTC)