Relationship between anogenital distance and cryptorchidism in human newborns / 中华男科学杂志

<p><b>OBJECTIVE</b>To explore the relation of the anogenital distance (AGD) with cryptorchidism in male newborns.</p><p><b>METHODS</b>This study included 350 male infants delivered in two community hospitals between September 2013 and September 2014. Within 24 hours after birth, a pediatric surgeon measured the AGD of the neonates and determined whether they had cryptorchidism. According to the testicular position, we divided the undescended testes into three types: upper scrotal, inguinal, and non-palpable.</p><p><b>RESULTS</b>Totally 39 cases of cryptorchidism were found in the 350 newborns. The AGD of the cryptorchidism infants was significantly shorter than that of the normal neonates ([2.01 ± 0.22] vs [2.35 ± 0.19] cm, P < 0.01), and statistically significant differences remained even when preterm and low birth-weight infants were excluded ([2.32 ± 0.14] vs [2.06 ± 0.19] cm; (2.37 ± 0.17) cm vs (2.12 ± 0.12) cm, all P < 0.01). The newborns with higher-position cryptorchidism had a shorter AGD, though with no significant difference (F = 0.434, P > 0.05). No significant differences were observed in the AGD between unilateral and bilateral cryptorchidism ([1.96 ± 0.13] vs [2.02 ± 0.17] cm, P > 0.05).</p><p><b>CONCLUSION</b>Shorter AGD is associated with a higher incidence of cryptorchidism in male newborns. AGD could serve as a potential biomarker for disruption of androgen action during the male programming window period.</p>

Staged hypospadias surgery for adult males / 中华男科学杂志

<p><b>OBJECTIVE</b>To explore the necessity of staged hypospadias surgery for adult men in order to improve the success rate of operation.</p><p><b>METHODS</b>We retrospectively analyzed 52 cases of hypospadias treated in our department from January 2004 to January 2012. The patients were adult males at the mean age of 22 years and all had a history of urethroplasty, with curvature of the penis and scar tissues on the penile skin. We removed the scarred fibrous tissues on the ventral cavernosa and cut off the urethral plate following foreskin-degloving. For those still with penile curvature, we straightened the penis by plication of the dorsal tunica albuginea, with the length of the anterior urethral defect > 50% of that of the penis after penis-straightening. The patients were assigned to group 1 (n = 20) to receive stage-I foreskin vascular pedicle flap urethroplasty and group 2 (n = 32) to undergo foreskin-shaping at the ventral aspect of the penis following penile straightening to prepare the urethra plate for stage-II Duplay urethroplasty after 6-12 months.</p><p><b>RESULTS</b>The success rates of urethroplasty were 25 and 56.3% in groups 1 and 2, respectively, with the post-urethroplasty incidence rates of urinary fistula of 50 and 21.9%, urethral stricture of 15 and 9.4%, local wound infection of 30 and 25%, and urethral rupture of 20 and 12.5%. There were statistically significant differences between the two groups in the incidence of urinary fistula and the success rate of urethroplasty, but not in urethral stricture, local wound infection and urethral rupture.</p><p><b>CONCLUSION</b>For adult hypospadias patients with a history of urethroplasty, especially those with obvious penile curvature, long urethral defect and insufficient foreskin, staged hypospadias surgery is preferable, which can dramatically increase the success rate of second-stage urethroplasty.</p>