[Hypospadias in infancy I) pathophysiologic considerations II) hormonal balance studies (author's transl)].
Animal studies (Goldman, Jost) and test results in patients with hypospadias (Bongiovanni, Zachmann, Knorr) put up the question, whether all forms of hypospadias could be caused by a disturbance or peculiarity of the adrenal or gonadal androgen metabolism. Healthy volunteers and boys with glandal, penile and scrotal hypospadias were examined for their basal hormon status and response to stimulation. The following test-results are uniform, however due to the small number of cases, we would like to use these data more as a suggestion for peculiarities of the androgen metabolism, these are: 1. signs of quantitatively decreased testosteron production. 2. signs of qualitatively deranged testosteron-biosynthesis in patients with hypospadias due to a) decrease in certain enzymes in the testosteron-biosyntheticpathway (3-beta-hydroxysteroid-dehydrogenase, 17,20-desmolase, 17-beta-hydroxysteroid oxidoreductase) b) increased peripheral conversion of androgen metabolites 3. signs of a suggested "saving" of androgens in the catabolism of those compounds and, last not least 4. signs of gonadal transformation of the adrenals, seen by increased adrenal androgen production and an adrenal transformation of the gonads, which can ultimately be considered as faulty differentiation of these 2 organ systems.