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Objective: Impact of environmental, maternal, paternal, and fetal factors on the development of hypospadias have been questioned in association with disrupted hormonal balance. We aimed to examine the association between maternal progesterone use and the associated risk factors and hypospadias., Materials and Methods: There were 429 male children as the cases with hypospadias (n = 280, Group 1) and the controls without hypospadias (n = 149, Group 2). Those working in agriculture and industry, cleaners, and hairdressers were determined as risky occupational groups concerning the exposure of estrogenic endocrine disrupters. The association of progestin usage and the other risk factors with hypospadias were the study outcomes., Results: The median gestational age was significantly lower in Group 2 (p = 0.019). Prematurity was more common in Group 1 (p = 0.043). Although the median birth weight in Group 1 was significantly lower (p < 0.001), there was no significant difference between the ratios of low birth weight babies in the groups. The risky occupations were more frequently detected in Group 2 (p = 0.001). The rate and duration of progestin usage in Group 1 were significantly higher than that in Group 2 (p < 0.001)., Conclusion: Low birth weight and the use and duration of progestins during pregnancy were significantly associated with increased hypospadias risk., Competing Interests: Declaration of competing interest The authors have no conflicts interest relevant to this article., (Copyright © 2021. Published by Elsevier B.V.)

Background and Aims: Hypospadias is a common congenital malformation in pediatric patients. Surgical repair of this malformation is a painful procedure and has long-term effects. Pudendal and penile nerve blocks are commonly preferred techniques for maintaining postoperative analgesia. However, the conventional landmark-based penile block technique involves numerous potential complications and provides a shorter analgesic period compared to the pudendal block. A promising ultrasound-guided dorsal penile nerve block was recently described. We aimed to compare the analgesic effectiveness of ultrasound-guided penile nerve block with that of neurostimulator-guided pudendal nerve block., Method: Thirty-three patients aged 1-7 years were included in this prospective, double-blinded, randomized controlled trial. Patients were divided into two groups and received either ultrasound-guided dorsal penile nerve block or neurostimulator-guided pudendal nerve block. All blocks were performed by the same two anesthesiologists, and the same surgeons performed the surgical procedures. The Face, Legs, Activity, Cry, and Consolability (FLACC) scale was used for postoperative pain management. The primary outcome of the study was time to first analgesic requirement. Secondary outcomes were FLACC scores at different time points, and types and cumulative doses of analgesic drugs., Results: Dorsal penile nerve block provided longer analgesia than pudendal nerve block (32.29 ± 5.47 hours and 21.13 ± 3.53 hours, respectively; differences in mean: 11.16, 95% CI: 7.873-14.465) (P < .001). FLACC scores at the time of first analgesic requirement were significantly lower in dorsal penile nerve block group than pudendal nerve block group (median [IQR]: 2 [2-2.5] and 3 [3-5], respectively; differences in median: -1, 95% CI: -1.851 to -0.149) (P < .001)., Conclusion: Ultrasound-guided dorsal penile nerve block provided a longer analgesic period and reduced opioid consumption compared to neurostimulator-guided pudendal nerve block., (© 2019 John Wiley & Sons Ltd.)