Skip to main content
SpringerLink
Log in

Normal Development of the Penis and Urethra

  • Chapter
  • First Online:
Hypospadias Surgery

  • 1309 Accesses

Abstract

The embryology of the penis and urogenital region remains controversial. This is due to several factors including extrapolation of animal studies to the human, considerable differences in length or age of the embryos at the same developmental stage among different authors, and different terminologies used by different authors. The description in this chapter is based on the available description of the embryological development of the human penis and urethra, the histochemical study of 15 human embryos and fetuses, and the clinical and operative findings of more than 8000 patients with hypospadias. The chapter starts by describing the developmental process, supported by intrauterine photos and histological sections. Review of literature and current theories of urethral development are discussed in Sect. 3.3. The “migration hypothesis” is described in detail to explain the development of the human penis and urethra.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
eBook
USD 16.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 109.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 159.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Abbreviations

AM:

Anal membrane

AT:

Anal tubercle

CR:

Crown-rump

CRL:

Crown-rump length

GA:

Gestational age

GL:

Glans

GM:

Genital membrane

GT:

Genital tubercle

H&E:

Hematoxylin and eosin

ICPs:

Intracavernosal pillars

LS:

Longitudinal section

LSF:

Labioscrotal folds

UF:

Urogenital fold

References

  1. Van Der Werff JFA, Nievelstein RAJ, Brands E, Luijsterburg AJM, Vermeij-Keers C. Normal development of the male anterior urethra. Teratology. 2000; https://doi.org/10.1002/(SICI)1096-9926(200003)61:3<172::AID-TERA4>3.0.CO;2-B.

  2. Hynes PJ, Fraher JP. The development of the male genitourinary systems: III. The formation of the spongiose and glandar urethra. Br J Plast Surg. 2004; https://doi.org/10.1016/j.bjps.2003.08.017.

  3. Forsberg JG. On the development of the cloaca and the perineum and the formation of the urethral plate in female rat embryos. J Anat. 1961;95:423–35.

    CAS  PubMed  PubMed Central  Google Scholar 

  4. Kluth D, Lambrecht W, Reich P. Pathogenesis of hypospadias-more questions than answers. J Pediatr Surg. 1988; https://doi.org/10.1016/S0022-3468(88)80322-1.

  5. Penington EC, Hutson JM. The urethral plate - does it grow into the genital tubercle or within it? BJU Int. 2002; https://doi.org/10.1046/j.1464-410X.2002.02656.x.

  6. Barnstein NJ, Mossman HW. The origin of the penile urethra and bulbo-urethral glands with particular reference to the red squirrel (Tamiasciurus hudsonicus). Anat Rec. 1938; https://doi.org/10.1002/ar.1090720107.

  7. Tourneux F. Sur le développement et l’évolution du tubercule génital chez le foetus humain. J l’Anatomie la Physiol. 1889;24:503–17.

    Google Scholar 

  8. Van Der Putte SCJ, Neeteson FA. The pathogenesis of hereditary congenital malformations of the anorectum in the pig. Acta Morphol Neerl Scand. 1984;22(1):17–40.

    PubMed  Google Scholar 

  9. Kanagasuntheram R, Anandaraja S. Development of the terminal urethra and prepuce in the dog. J Anat. 1960;94(Pt 1):121.

    CAS  PubMed  PubMed Central  Google Scholar 

  10. Glenister TW. The origin and fate of the urethral plate in man. J Anat. 1954;288:413–8.

    Google Scholar 

  11. Nievelstein RAJ, Van Der Werff JFA, Verbeek FJ, Valk J, Vermeij-Keers C. Normal and abnormal embryonic development of the anorectum in human embryos. Teratology. 1998; https://doi.org/10.1002/(SICI)1096-9926(199802)57:2<70::AID-TERA5>3.0.CO;2-A.

  12. de Vries PA, Friedland GW. The staged sequential development of the anus and rectum in human embryos and fetuses. J Pediatr Surg. 1974; https://doi.org/10.1016/0022-3468(74)90115-8.

  13. Van Der Putte SCJ. The development of the perineum in the human. Adv Anat Embryol Cell Biol. 2005;177:1–131.

    Article  Google Scholar 

  14. Pechriggl EJ, Bitsche M, Blumer MJF, Fritsch H. The male urethra: spatiotemporal distribution of molecular markers during early development. Ann Anat. 2013; https://doi.org/10.1016/j.aanat.2013.01.008.

  15. Hadidi AT, Roessler J, Coerdt W. Development of the human male urethra: a histochemical study on human embryos. J Pediatr Surg. 2014; https://doi.org/10.1016/j.jpedsurg.2014.01.009.

  16. Liu X, Liu G, Shen J, Yue A, Isaacson D, Sinclair A, Cao M, Liaw A, Cunha GR, Baskin L. Human glans and preputial development. Differentiation. 2018; https://doi.org/10.1016/j.diff.2018.08.002.

  17. Baskin LS, Erol A, Jegatheesan P, Li Y, Liu W, Cunha GR. Urethral seam formation and hypospadias. Cell Tissue Res. 2001; https://doi.org/10.1007/s004410000345.

  18. Hsu GL, Lin CW, Hsieh CH, Hsieh JT, Chen SC, Kuo TF, Ling PY, Huang HM, Wang CJ, Tseng GF. Distal ligament in human glans: a comparative study of penile architecture. J Androl. 2005; https://doi.org/10.2164/jandrol.04145.

  19. Liu G, Liu X, Shen J, Sinclair A, Baskin L, Cunha GR. Contrasting mechanisms of penile urethral formation in mouse and human. Differentiation. 2018; https://doi.org/10.1016/j.diff.2018.05.001.

  20. Streeter GL. Developmental horizons in human embryos. Description of age groups XIX, XX, XXI, XXII, and XXIII, being the fifth issue of a survey of the Carnegie collection. Contr Embryol Corneg Instn. 1951;36:29–39.

    Google Scholar 

  21. Jirasek JE. An atlas of human prenatal developmental mechanics. London: CRC Press; 2004. https://doi.org/10.3109/9780203487297.

    Book  Google Scholar 

  22. O’Rahilly RR, Müller F. Human embryology & teratology. 3rd ed. New York: John Wiley & Sons; 2001.

    Google Scholar 

  23. Moore KL, Persaud TVN. The developing human: clinically oriented embryology. 8th ed. Philadelphia: Saunders; 2007.

    Google Scholar 

  24. van der Putte SCJ. Hypospadias and associated penile anomalies: a histopathological study and a reconstruction of the pathogenesis. J Plast Reconstr Aesthetic Surg. 2007; https://doi.org/10.1016/j.bjps.2006.05.020.

  25. Baskin LS, Erol A, Li YW, Cunha GR. Anatomical studies of hypospadias. J Urol. 1998; https://doi.org/10.1016/S0022-5347(01)62711-3.

  26. Baskin L, Shen J, Sinclair A, Cao M, Liu X, Liu G, Isaacson D, Overland M, Li Y, Cunha GR. Development of the human penis and clitoris. Differentiation. 2018; https://doi.org/10.1016/j.diff.2018.08.001.

  27. Kurzrock EA, Baskin LS, Cunha GR. Ontogeny of the male urethra: theory of endodermal differentiation. Differentiation. 1999; https://doi.org/10.1046/j.1432-0436.1999.6420115.x.

  28. Keibel F, Mall FP. Development of the urogenital organs. In: Manual of human embryology. 1st ed. Philadelphia: JB Lippincott; 1912. p. 752–979.

    Google Scholar 

  29. Spaulding MH. The development of the external genitalia in the human embryo. Contr Embryol Corneg Instn. 1921;61:85.

    Google Scholar 

  30. Glenister TW. A correlation of the normal and abnormal development of the penile urethra and of the infra-umbilical abdominal wall. Br J Urol. 1958; https://doi.org/10.1111/j.1464-410X.1958.tb06224.x.

  31. Larsen WJ. Human embryology. 3rd ed. New York: Churchill Livingstone; 1991.

    Google Scholar 

  32. Fleishmann A. Die Stilcharactere am Urodaeum und Phallus. Morph Jahrb. 1907;36:570–601.

    Google Scholar 

  33. Politzer G. Über die Entwicklung des Dammes beim Menschen. Z Anat Entwicklungsgesch. 1931; https://doi.org/10.1007/BF02119294.

  34. Van Der Putte SCJ, Neeteson FA. The normal development of the anorectum in the pig. Acta Morphol Neerl Scand. 1983;21(2):107–32.

    PubMed  Google Scholar 

  35. van der Putte SCJ. Normal and abnormal development of the anorectum. J Pediatr Surg. 1986;21:434–40.

    Article  Google Scholar 

  36. Kluth D, Fiegel HC, Geyer C, Metzger R. Embryology of the distal urethra and external genitals. Semin Pediatr Surg. 2011; https://doi.org/10.1053/j.sempedsurg.2011.03.003.

  37. Clarke PGH, Clarke S. Nineteenth century research on naturally occurring cell death and related phenomena. Anat Embryol (Berl). 1996; https://doi.org/10.1007/BF00214700.

  38. Glücksmann A. Cell deaths in normal vertebrate ontogeny. Biol Rev. 1951; https://doi.org/10.1111/j.1469-185X.1951.tb00774.x.

  39. Baskin LS. Hypospadias and urethral development. J Urol. 2000; https://doi.org/10.1016/S0022-5347(05)67861-5.

  40. Wyllie AH, Kerr JFR, Currie AR. Cell death: the significance of apoptosis. Int Rev Cytol. 1980; https://doi.org/10.1016/S0074-7696(08)62312-8.

  41. Vermeij Keers C, Mazzola RF, Van der Meulen JC, Strickler M. Cerebro-craniofacial and craniofacial malformations: an embryological analysis. Cleft Palate J. 1983;20(2):128–45.

    CAS  PubMed  Google Scholar 

  42. Hadidi AT. Perineal hypospadias; The bilateral based (BILAB) skin flap technique. J Pediatr Surg. 2014; https://doi.org/10.1016/j.jpedsurg.2013.09.067.

  43. Altemus AR, Hutchins GM. Development of the human anterior urethra. J Urol. 1991; https://doi.org/10.1016/S0022-5347(17)38008-4.

  44. Seifert AW, Harfe BD, Cohn MJ. Cell lineage analysis demonstrates an endodermal origin of the distal urethra and perineum. Dev Biol. 2008; https://doi.org/10.1016/j.ydbio.2008.03.017.

  45. Williams DI. The development and abnormalities of the penile urethra. Acta Anat (Basel). 1952; https://doi.org/10.1159/000140742.

  46. Wood-Jones F. Report LXXXIX: the nature of the malformations of the rectum and urogenital passages. Br Med J. 1904; https://doi.org/10.1136/bmj.2.2294.1630.

  47. Hart DB. On the role of the developing epidermis in forming sheaths and lumina to organs, illustrated specially in the development of the prepuce and urethra. J Anat Physiol. 1908;42:50.

    Google Scholar 

  48. Hunter R. Notes on the development of the prepuce. J Anat. 1935;70(Pt 1):68–75.

    CAS  PubMed  PubMed Central  Google Scholar 

  49. Baskin LS, Cunha GR. Embryology of the genitourinary tract in Partin A. In: Partin AW, Peters CA, Kavoussi LR, Dmochowski R, Wein AJ, editors. Campbell-Walsh-Wein urology. 12th ed. Philadelphia: Elsevier; 2020. p. 305.

    Google Scholar 

  50. Hamilton WJ, Mossman HW. Human embryology. Cambridge: The Williams and Wilkins Company; 1972.

    Book  Google Scholar 

  51. Smith ED. The history of hypospadias. Pediatr Surg Int. 1997; https://doi.org/10.1007/s003830050073.

  52. Szenes A. Über Geschlechtsunterschiede am äussern Genitale menschlicher Embryonen, nebst Bemerkungen über die Entwicklung des inneren Genitales. Morph Jahrb. 1925;54:65–135.

    Google Scholar 

  53. Wartenberg H. Entwicklung der Genitalorgane und Bildung der Gameten. In: Hinrichsen KV, editor. Humanembryologie. Berlin: Springer; 1993. p. 815–22.

    Google Scholar 

  54. Arey LB. Developmental anatomy, 7th revise. Philadelphia: Saunders; 1965.

    Google Scholar 

  55. Rabinowitz R. Congenital anomalies of the urinary and genital tracts. Stephens F.D., Smith E.D. and Hutson J.M.: Congenital anomalies of the urinary and genital tracts. Oxford: Isis Medical Media 1996. 472 pages. J Urol. 1997; https://doi.org/10.1016/s0022-5347(01)65161-9.

  56. Sadler TW, Langman J. Langman’s medical embryology. 10th ed. Baltimore: Lippincott Williams & Wilkins; 2006.

    Google Scholar 

  57. Moore KL, Persaud TVN. The developing human. In: Clinically oriented embryology. 6th ed. Philadelphia: Saunders; 1998. p. 293–347.

    Google Scholar 

  58. Retterer E, Neuville H. C R Soc Biol. XXVIII. Paris; 1915. p 388.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Hypospadias Center and Pediatric Surgery Department, Sana Klinikum Offenbach, Academic Teaching Hospital of the Johann Wolfgang Goethe University, Offenbach, Frankfurt, Germany

    Ahmed T. Hadidi

Authors
  1. Ahmed T. Hadidi
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Hypospadias Center and Pediatric Surgery Department, Sana Klinikum Offenbach, Academic Teaching Hospital of the Johann Wolfgang Goethe University, Offenbach, Frankfurt, Germany

    Ahmed T. Hadidi

Rights and permissions

Reprints and permissions

Copyright information

© 2022 The Author(s), under exclusive license to Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Hadidi, A.T. (2022). Normal Development of the Penis and Urethra. In: Hadidi, A.T. (eds) Hypospadias Surgery. Springer, Cham. https://doi.org/10.1007/978-3-030-94248-9_3

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-94248-9_3

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-94247-2

  • Online ISBN: 978-3-030-94248-9

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation