Associations Among Hypospadias, Cryptorchidism, Anogenital Distance, And Endocrine Disruption

Main Category: Urology / Nephrology
Article Date: 13 Jun 2008 - 3:00 PDT

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UroToday.com - Our study examined a possible association of endocrine disruptors, hypospadias, cryptorchidism and reduced anogenital distance. In many mammals, including humans, anogenital distance is longer in males than females, suggesting this phenotype in under hormonal influence. Recent studies have reported that anogenital distance is reduced in male infants exposed to high in utero levels of phthalates, putative endocrine disruptors, in multiple species.

Disagreement exists over which definitions of anogenital distance (AGD) are best and what are the ideal instruments for measurement. We examined 3 definitions of AGD using a flexible ruler which conformed to the natural curves of the perineum. All children were under anesthesia at the time of measurement, which improved accuracy by eliminating any motion artifact.

We compared anogenital distance in boys with hypospadias (47 patients), undescended testes (32) and normal genitals (40). We also examined whether various demographic and morphometric parameters were possible confounding variables. Groups were similar with respect to age, height, body-mass index and related age-adjusted percentiles. Anogenital distance was significantly shorter for hypospadiac boys compared to cryptorchid and normal boys (P< 0.001). Normal and cryptorchid boys were not significantly different.

In conclusion, our preliminary data indicate that human hypospadias and cryptorchidism may be associated with shortened anogenital distance. Further studies will be required to confirm these findings and determine their etiology.

Written by Ben Breyer, MD, as part of Beyond the Abstract on UroToday.com.

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