| Background: Hypospadias is a common male birth defect that has shown widespread
variation in reported prevalence estimates. Many countries have reported increasing
trends over recent decades.
Objective: To analyze the prevalence and trends of hypospadias for 27 international
programs over a 31-yr period.
Design, setting, and participants: The study population included live births, stillbirths,
and elective terminations of pregnancy diagnosed with hypospadias during 1980–2010
from 27 surveillance programs around the world.
Outcome measurements and statistical analysis: We used joinpoint regression to analyze
changes over time in international total prevalence of hypospadias across programs,
prevalence for each specific program, and prevalence across different degrees of severity
of hypospadias.
Results and limitations: The international total prevalence of hypospadias for all years
was 20.9 (95% confidence interval: 19.2–22.6) per 10 000 births. The prevalence for
each program ranged from 2.1 to 39.1 per 10 000 births. The international total
prevalence increased 1.6 times during the study period, by 0.25 cases per 10 000 births
per year (p < 0.05). When analyzed separately, there were increasing trends for first-,
second-, and third-degree hypospadias during the early 1990s to mid-2000s. The
majority of programs (61.9%) had a significantly increasing trend during many of
the years evaluated. Limitations include known differences in data collection methods
across programs.
Conclusions: Although there have been changes in clinical practice and registry ascertainment
over time in some countries, the consistency in the observed increasing trends
across many programs and by degrees of severity suggests that the total prevalence of
hypospadias may be increasing in many countries. This observation is contrary to some
previous reports [17TD$DIF]that suggested that the total prevalence of hypospadias was no longer
increasing in recent decades.
Patient summary: We report on the prevalence and trends of hypospadias among
27 birth defect surveillance systems, which indicate that the prevalence of hypospadias
continues to increase internationally |