Low risk of impaired testicular sertoli and Leydig cell functions in boys with isolated hypospadias
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Testicular dysfunction was observed in 57.1% and androgen end- organ defects in 7.2% of patients with hypospadias associated with cryptorchidism, micropenis, or ambiguous genitalia. In the remaining 35.7%, the disorder was idiopathic. The presence of ambiguous genitalia predicted the existence of testicular or end- organ dysfunction with 81.8% specificity. Isolated hypospadias was associated in 14.8% of patients with testicular dysfunction and in 6.5% of cases with end- organ defects; in 78.7% of cases, the condition was idiopathic. The occurrence of isolated hypospadias ruled out the existence of testicular or end- organ disorders with 80.0% sensitivity. Altogether our data indicate that the risk for the existence of an underlying testicular or end- organ dysfunction is low in patients with isolated hypospadias ( odds ratio, 0.13; 95% confidence interval, 0.05 - 0.36; P < 0.001). Conclusions: Boys with isolated hypospadias are more likely to have normal endocrine testicular and androgen end- organ functions, suggesting that transient disruption of morphogenetic events in early fetal life may be the predominant underlying cause.