Hypospadias. Anatomy, Embryology, and Reconstructive Techniques

Hypospadias is one of the most common congenital anomalies that can be treated with surgical reconstruction. The etiology in the majority of cases of hypospadias remains elusive. Androgens are clearly critical for penile development; however, defects in androgen metabolism and/or the androgen receptor explain only a small subset of patients with hypospadias. This paper reviews the present strategies to understanding the etiology of hypospadias. This is followed by a review of the anatomy of the male and female genitalia with an emphasis on reconstructive implications. Finally, current techniques for hypospadias repair are reviewed.