A high hypospadias rate in The Netherlands
article
Reports on increasing hypospadias trends are based on birth defect registries, which are prone
to inaccuracy. We assessed the prevalence of hypospadias precisely, by prospective examination of all newborns in
Rotterdam over a 2-year period. METHODS: A total of 7292 consecutiye male births were examined for the
presence of hypospadias, classified by severity. RESULTS: The frequency of hypospadias in newborn boys was
0.73Vo (5317292). The rate among live births was 38 per 10 000, which is 6 times the previously reported rate for
the Southwestern Netherlands (6.2) (P < 0.0001). This registry excludes glandular hypospadias. Without glandular
cases, our rate is 26 per 10 000, which is still 4-fold higher (P < 0.0001). The ratio of minor to major hypospadias
was 0.3. In 79% of cases, surgery was indicated. CONCLUSIONS: We found a 4-fold higher than expected
hypospadias rate, which may be explained by case ascertainment differences. The proportion of major cases was
higher than generally assumed. This study provides evidence for substantial geographical differences. Explanations
for temporal and geographical differences need to be explored. To monitor hypospadias rates and trends accurately
complete case ascertainment, including standardized classification of severity, is warranted
to inaccuracy. We assessed the prevalence of hypospadias precisely, by prospective examination of all newborns in
Rotterdam over a 2-year period. METHODS: A total of 7292 consecutiye male births were examined for the
presence of hypospadias, classified by severity. RESULTS: The frequency of hypospadias in newborn boys was
0.73Vo (5317292). The rate among live births was 38 per 10 000, which is 6 times the previously reported rate for
the Southwestern Netherlands (6.2) (P < 0.0001). This registry excludes glandular hypospadias. Without glandular
cases, our rate is 26 per 10 000, which is still 4-fold higher (P < 0.0001). The ratio of minor to major hypospadias
was 0.3. In 79% of cases, surgery was indicated. CONCLUSIONS: We found a 4-fold higher than expected
hypospadias rate, which may be explained by case ascertainment differences. The proportion of major cases was
higher than generally assumed. This study provides evidence for substantial geographical differences. Explanations
for temporal and geographical differences need to be explored. To monitor hypospadias rates and trends accurately
complete case ascertainment, including standardized classification of severity, is warranted
TNO Identifier
470531
Source
Human Reproduction, 117(4), pp. 1112-1115.
Pages
1112-1115
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