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Title: Hypospadias Prevalence and Trends in International Birth Defect Surveillance Systems, 1980-2010
Authors: Yu, Xiao 
Nassar, Natasha 
Mastroiacovo, Pierpaolo 
Canfield, Mark 
Groisman, Boris 
Bermejo-Sánchez, Eva 
Ritvanen, Annukka 
Kiuru-Kuhlefelt, Sonja 
Benavides, Adriana 
Sipek, Antonin 
Pierini, Anna 
Bianchi, Fabrizio 
Källén, Karin 
Gatt, Miriam 
Morgan, Margery 
Tucker, David 
Canessa, M Aaurora 
Gajardo, Rosa 
Mutchinick, Osvaldo M 
Szabova, Elena 
Csáky-Szunyogh, Melinda 
Tagliabue, Giovanna 
Cragan, Janet D 
Nembhard, Wendy N 
Rissmann, Anke 
Goetz, Dorit 
Bower, Carol 
Baynam, Gareth 
Lowry, R Brian 
Leon, Juan A 
Luo, Wei 
Rouleau, Jocelyn 
Zarante, Ignacio 
Fernandez, Nicolas 
Amar, Emmanuelle 
Dastgiri, Saeed 
Contiero, Paolo 
Martínez-de-Villarreal, Laura E 
Borman, Barry 
Bergman, J E H 
de Walle, Hermien E K 
Hobbs, Charlotte A 
Nance, Amy E 
Agopian, A J 
Keywords: Hipospadias;Prevalencia
Issue Date: Oct-2019
Journal: European urology 
Abstract: 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 10000 births. The prevalence for each program ranged from 2.1 to 39.1 per 10000 births. The international total prevalence increased 1.6 times during the study period, by 0.25 cases per 10000 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 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.
DOI: 10.1016/j.eururo.2019.06.027
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