Objectives: Hypospadias, a common birth defect, has shown widespread variation in reported rates and temporal trends across countries over the last 30 years. The aim of this study was to determine the prevalence and trends of hypospadias in an Australian population.
Design, setting, patients: Population-based study of all male infants born in Western Australia (WA) between 1980 and 2000 diagnosed with hypospadias and notified to the WA Birth Defects Registry.
Main outcome measures: Prevalence of hypospadias, birth outcome and association with other congenital anomalies; stratified by degree-of-severity.
Results: A total of 1788 cases of hypospadias were registered in WA in 1980-2000 with overall prevalence of 34.8 (95%Confidence Interval, 33.2 to 36.4) cases per 10,000 births. The prevalence increased 2.0% per annum (1.2% to 2.8%) from 27.9 in 1980 to 43.2 per 10,000 births in 2000 (P<0.001). Hypospadias was diagnosed as mild in 84% of cases, 11% were moderate- severe and 5% unspecified; with moderate-severe hypospadias almost doubling over time (P<0.01). There were 1465 (82%) cases of isolated hypospadias and 18% with co-existing anomalies. Infants with co-existing genital (Relative Risk(RR) 4.5; 3.3 to 6.1) or non- genital (RR 1.5; 1.0 to 2.2) anomalies were more likely to have moderate-severe hypospadias compared with isolated cases.
Conclusion: This study overcomes many limitations of previous reports. Hypospadias affects one in 231 births and has increased significantly over the last 20 years. Future investigation of aetiology of hypospadias is important to identify potentially modifiable risk factors and ensure optimal male reproductive health in the future.
- congenital abnormalities