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Management of Hypospadias in Patients with Disorders of Sexual Development (DSD)

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Hypospadiology

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Abstract

Though hypospadias (HP) is one of the most common congenital malformations of the male genitalia, decision-making with regard to surgical management has always brought forth many challenges to the treating surgeons, and these challenges further increase when it presents as a part of the spectrum of disorder of sex development (DSD) as ambiguous genitalia. The controversies in the management of this unique subgroup start right from the terminology to the indication for evaluation, gender assignment, need for surgery, the timing of surgery, hormone supplementation, etc. Of late, the ethics and rationale of early surgery in this subgroup of patients have also come into focus. This just exemplifies the fact that the management of hypospadias in the context of DSD is a complex issue that needs to be managed by a multidisciplinary team that includes experts in the fields of pediatric urology, endocrinology, genetics, psychiatry who need to work closely with families of these patients, preferably in dedicated centers. An individualized patient and family-centered care is required for these children as management of this condition is a life-long process that needs to address medical issues and developmental, psychological, sexual, reproductive, and social issues that become more prominent at later times in a patient’s life. We have attempted to give an overview of the management of HP in patients with DSD with a specific focus on the various unique considerations and controversies involved in the management of this cohort of patients.

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Author information

Authors and Affiliations

  1. Consultant Urologist, Department of Urology, Sri Sathya Sai Institute of Higher Medical Sciences, Puttaparthi, India

    P. Ashwin Shekar

  2. Bhat’s Hypospadias and Reconstructive Urology Hospital and Research Centre, Jaipur, Rajasthan, India

    Amilal Bhat

  3. Department of Urology, Jaipur National University Institute for Medical Sciences and Research Centre, Jaipur, Rajasthan, India

    Amilal Bhat

  4. Department of Urology, Dr. S.N. Medical College, Jodhpur, Rajasthan, India

    Amilal Bhat

  5. Department of Urology, S.P. Medical College, Bikaner, Rajasthan, India

    Amilal Bhat

  6. P.G. Committee Medical Council of India, New Delhi, India

    Amilal Bhat

  7. Academic and Research Council of RUHS, Jaipur, Rajasthan, India

    Amilal Bhat

Authors
  1. P. Ashwin Shekar
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Editors and Affiliations

  1. Bhat’s Hypospadias and Reconstructive Urology Hospital and Research Centre, Jaipur, Rajasthan, India

    Amilal Bhat

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Ashwin Shekar, P., Bhat, A. (2022). Management of Hypospadias in Patients with Disorders of Sexual Development (DSD). In: Bhat, A. (eds) Hypospadiology . Springer, Singapore. https://doi.org/10.1007/978-981-16-8395-4_23

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  • DOI: https://doi.org/10.1007/978-981-16-8395-4_23

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