Risk factors for hypospadias: a prospective single-center study from Ghana.

INTRODUCTION

Hypospadias is a common congenital defect in boys, though its causes are mostly unknown, likely arising from genetic and environmental factors. We analyzed hypospadias cases at our center to identify prevalence of risk factors.

METHODS

We collected data prospectively on boys with hypospadias and their parents who visited our center from January 2023 to December 2024. The urology unit diagnoses two new cases of hypospadias each month. Therefore, 51 patients were recruited, expecting 5% of the data to be unusable. Data collected and analyzed included the child's gestational age, birth weight, type of hypospadias, associated abnormalities, parents' ages, exposure to organophosphate pesticides and phytoestrogens, maternal contraceptive use during pregnancy, and a history of subfertility or hypospadias in the father.

RESULTS

This study involving 51 boys aged 2 months to 11 years with hypospadias and their parents revealed that 84.3% were born at term, while 45.1% had low birth weights, with no correlation between birth weight and hypospadias type (p = 0.35). Most mothers (54.9%) and fathers (86.3%) were 30 or older at birth, and 45.1% of mothers and 27.5% of fathers frequently consumed phytoestrogen-rich foods. Exposure to organophosphate pesticides was noted by 17.6% of mothers and 11.7% of fathers. During pregnancy, 15.7% of mothers used oral contraceptives and 5.9% used progestogens. Among fathers, 11.7% had a history of subfertility, and 3.9% had cryptorchidism, with no father having hypospadias.

CONCLUSION

Low birth weight, advanced parental age, and exposure to phytoestrogens and organo-pesticides are associated with hypospadias in our patients.