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EP236: Seeking clarity on hypospadias and intersex conditions | PUTTING DR G ON THE SPOT
The Star
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8/18/2024
Consultant urologist Dr George Lee Eng Geap, or a.k.a Dr G, enlightens a reader on more a condition called hypospadias as he has experienced problems with the opening on the underside of his penis as well as undescended testicle.
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00:00
In the month of August, we've been focusing on various conditions labelled as intersex.
00:07
In fact, intersex is actually quite a wide umbrella of conditions that actually has no
00:14
definitive definition.
00:16
And one condition we're going to talk about today sometimes can be considered intersex
00:21
and some experts do not consider this to be intersex and it's a condition called hypospadias.
00:30
Hypospadias, as we have discussed in paediatric condition before, is a condition that affects
00:41
one in 200 to 300 boys born.
00:48
What exactly is it?
00:49
In fact, it's a condition characterised by three things.
00:53
Number one, the opening of the tip of the penis actually is displaced and it's displaced
01:00
downwards.
01:01
Number two, as a result of that, the penis will bend downwards.
01:06
Number three is that it will create a naturally hooded appearance of the foreskin.
01:13
And the three conditions itself actually constitute a condition called hypospadias.
01:20
Just 90% of the time, actually it's quite mild and only affects the very, very tip of
01:27
the penis being displaced downwards.
01:30
So it is not significantly causing any problems.
01:34
However, 10% of hypospadias may have some problems generating some ambiguity of the
01:42
genitalia.
01:44
For example, if the hypospadias is causing opening of the penis to be in the bottom part
01:51
of the shaft of the penis, then the penis itself will look shorter and also 10% of this
01:57
condition is associated with undescended testicle and it appear to be causing ambiguous genitalia.
02:05
In reality, 99.99% of boys born with hypospadias actually is XY gene, so genetically a boy.
02:16
However, the actual, the growing part of the development is impeded.
02:24
For example, during gestation between the first five to eight weeks, there is a so-called
02:31
non-hormonal dependent development of external genitalia.
02:38
Between eight to 13 weeks, the male hormone, the testosterone, will influence the elongation
02:45
of the penis and the phallus.
02:48
If the woman, the mother, is exposed to some female hormone, for example, estrogen, or
02:56
the testosterone is not really actively causing the elongation of the penis, then hypospadias occur.
03:05
So by definition, that can actually cause nurture resulting the hypospadias.
03:12
However, we also know that boys who are twins, who are genetically identical, also has a
03:19
higher risk of hypospadias.
03:22
And that tells us that there's certain epigenes also influence hypospadias.
03:28
On that argument, some people classify boys with hypospadias as a condition that falls
03:36
under umbrella of intersex.
03:39
The reality is that the corrections of hypospadias is pretty easy.
03:43
Effectively, the operation will result in a circumcision, actually advancements of the
03:50
tip to the penis, and also straightening of the penis.
03:54
For the final week, we're going to talk about gender reassignment or gender reaffirming
04:00
operation.
04:01
So if you're interested to find out more about gender reassignment operation, stay
04:05
tuned for next week's Putting Dr. G on the Spot.
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