The Role Of Mullerian Inhibiting Substance In The Occrrence Of Male Hypospadias And The Long-Term Results Of Hypospadias Repairs

Objective To explore the role of mullerian inhibiting substance playing in theoccurrence of male hypospadias.Methods Fifty-four simple hypospadias patients and 36 patients which sufferedfrom other diseases were chosen as our research objects. Of the hypospadias patients,there were 11patients whose ages were less than 12months, 24 patients were from 13to 24months, and 19 patients were from 25 to 36months. Serum mullerian inhibitingsubstance, testosterone, and androstenedion were assayed, respectively. To comparethe relationgships in testosterone and mullerian inhibiting substance between the thetwo groups.Results The concetration of mullerian inhibiting substance in hypospadias groupwas significantly higher than that in control group, P<0.05. However, the concetrationof testosterone, or androstenedione in group hypospadias was significantly lower than that in control group, P<0.05. Furthermore the two- group patients were divided into 3 subgroups according their ages, respectively. The concetration of testosterone, orandrostenedione in group hypospadias whose ages were less than 12 months, and patients from 13 to 24 months was significantly lower than that in control group whose ages were less than 12 months, and patients from 13 to 24 months, P<0.05. And the higher concetration of mullerian inhibiting substance was negative relationship with the lower concetration of testosterone in hypospadias patients, andthe relative coefficient was negative 0.31 and 0.42, respectively.Conclusions Mullerian inhibiting substance maybe could inhibit the synthesizationof testosterone by inhibiting cytochrome P450cl7a hydroxylase/c_17-20lase geneexpreesion. Mullerian inhibiting substance plays a part in the occurrence ofhypospadias.Objective To follow-up the long-term outcome of hypospadias repairs, and explorefactors which could affect the long-term results of hypospadias repairsMethods Questionnaires were designed and mailed respectively to hypospadiaspatients, who underwent surgical treatments during 1982 to 1988 in Tongji hospitaland The First Pepeole's Hospital of Jinning. The data were analysed using statisticalmethods.Results Of 142 hypospadias patients, 102 returned the questionnaires. There wereno significant differences between the distal group and proximal group in education,occupation and economic status. The median age of the first spermatorrhea of diatalpatient was similar to that of the proximal patient. But the diatal hypospadias patientsoften held more negative attitude than the proximal patients in penile appraisals,micturition, sexual psychology, penile erction and ejaculation.Conclusions The short-term results of hypospadias repair could affect the long-termresults significantly, and good short-term results also predict long-term ones. Thetypes of hypospadias, procedures, and complications have significant influences onpredicting the long-term results of hypospadias repairs. In order to achieve goodlong-term results of hypospadias repairs, it is very important to operate earlier,enhance the successful rate of the first hypospadias repair, reduce early complications,and to improve the penile appearance.