Category Archives: Embryology

Letter writer disturbed by abortion support | Letters to the Editor | thebrunswicknews.com – Brunswick News

After reading several abortion-supporting letters, I needed to respond to their deeply disturbing lack of care for human life. They are advancing the culture of death. Very sad people support killing of innocent unborn babies in what should be their safest haven their mothers womb. Their arguments are illogical. Each child has unique, individual, unrepeatable DNA. When that child is killed in abortion, the unique human being can never be replicated. Sad. All for the right to choose. Right to choose what? Women should have choices in living their lives. But some choices are wrong like choosing to intentionally kill an innocent human being. Ive heard many say a womans life is ruined if pregnancies are sustained. In other words, kill a baby due to inconvenience.

Why is society choosing to devalue human life so callously and casually? It is not just a clump of cells. Embryology and science have proven this wrong, but pro-death activists spout this lie. A clump of cells doesnt have a heartbeat three weeks from conception. A local protester said he doesnt support killing babies. If you vote for politicians championing this evil against innocent children, then you support murder of the unborn. You cannot hide the truth. The abortion lobby uses verbal engineering, seeking to hide that truth. The left supports abortions up until birth. Voting for these radicals poses a threat to every new and existing human life.

Stop the madness and immorality. Vote pro-life. Babies lives depend on it!

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Letter writer disturbed by abortion support | Letters to the Editor | thebrunswicknews.com - Brunswick News

How spilled coffee inspired a Boston sperm-testing startup – The Boston Globe

Khaled Kteily might never have founded his Boston home health care startup, Legacy, if not for spilling a hot beverage in his lap.

The accident left him with second-degree burns around some sensitive areas. And when a friend mentioned he was having his sperm tested and saved before chemotherapy, Kteily decided he should also get tested in case the burns affected his future fertility.

A student at Harvards John F. Kennedy School, Kteily went to a Cambridge sperm bank, where he was quizzed about intimate details of his sexual history in the waiting room, then sent to the specimen collection room. As he sat in the dark, he tried not to think of how many people had sat in the same spot to perform the same task.

Everything about that experience was so dehumanizing for someone who just wanted to be proactive about their fertility, Kteily recalled.

But the experience also gave him the idea for Legacy, an at-home sperm testing and collection service. He set up the company at Harvards Innovation Labs in May 2018 and went through the startup accelerator Y Combinator in 2019. So far, Legacy has raised more than $45 million, including a $25 million round this year led by Bain Capital Ventures that also included celebrities DJ Khalid, Orlando Bloom, and Justin Bieber. (Including the celebs was part of our effort to de-stigmatize and normalize the conversation around infertility, Kteily said.)

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More chemicals in the environment, higher stress levels, and other illnesses are contributing to a decrease in male fertility, Kteily noted. Sperm concentration declined by 50 percent or more from 1973 to 2011, according to a widely cited study by the European Society of Human Reproduction and Embryology though a Harvard study last year challenged those findings.

Legacy offers sperm testing and storage at much lower prices than typical sperm banks. Charging about $300 upfront for testing plus about $100 per year for storage, Legacy is undercutting the industry by hundreds of dollars per year.

Its sometimes a challenge to conduct marketing like a typical health startup. Legacy wanted to run advertisements in Texas and New York using the word sperm, but the term was prohibited by the billboard companies.

Its the medical term, Kteily said. So thats one of the challenges you face working in a stigmatized industry like ours.

The latest effort at Legacy is a joint research project with the Veterans Health Administration and the agencys New England Center for Innovation Excellence, located in Bedford. Legacy will take sperm samples from veterans of recent conflicts and measure their fertility over time. Soldiers can be exposed to chemical toxins on the battlefield and also suffer other injuries that affect fertility.

We know based upon existing evidence that male veterans are at high risk of infertility, but we dont really know why, we dont have a good scientific reason, said Dr. Ryan Vega, chief officer for health care innovation and learning at the VA. The research project with Legacy is really aimed at trying to begin to put the puzzle together.

While both male and female veterans suffer from infertility problems, males are less likely to seek treatment, according to surveys conducted by the VA. The agency hopes Legacys project will also help it encourage more veterans to get help.

We want to make sure that we can present an opportunity for our veterans to have that space to have the conversations with their providers to seek care for infertility issues, Leandro DaSilva, acting director of the innovation excellence center, said.

In addition to its fertility services, Legacy is also expanding its services to include home testing for sexually transmitted diseases.

We believe that on the path to parenthood, there are a number of products and services that were going to be able to offer as part of our vision, which is to unlock sperm as a biomarker of health, Kteily said.

Aaron Pressman can be reached at aaron.pressman@globe.com. Follow him on Twitter @ampressman.

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How spilled coffee inspired a Boston sperm-testing startup - The Boston Globe

Merck Foundation CEO Acknowledged Zimbabwe First Lady’s Efforts as Ambassador of More than a Mother to Build Healthcare Capacity, Break Infertility S…

Merck Foundation CEO Acknowledged Zimbabwe First Ladys Efforts as Ambassador of More than a Mother to Build Healthcare Capacity, Break Infertility Stigma, and Support Girl Education

Mumbai, Maharashtra, India & Harare, Zimbabwe Business Wire India

Merck Foundation provided around 100 scholarships to doctors on 32 critical specialties in Zimbabwe.At the same occasions, Merck Foundation Zimbabwe Alumni Summit and Merck Foundation Awards ceremony were conducted

Merck Foundation and Zimbabwe First Lady announced the Call for Applications for 2 new categories of 2022 Awards for Media, Musicians, Fashion Designers, Filmmakers, students, and new potential talents in these fields

Merck Foundation Awards More Than a Mother 2022 to address issues such as: Breaking Infertility Stigma, Support Girls Education, End Child Marriage, End FGM, Stopping GBV, and/or Women Empowerment at all levels

Merck Foundation Awards Diabetes & Hypertension 2022 to promote a healthy lifestyle and raise awareness about the prevention and early detection of Diabetes & Hypertension

Senator Dr. Rasha Kelej, CEO of Merck Foundation, the philanthropic arm of Merck KGaA Germany, for the first time physically in Zimbabwe, officially launched their programs in partnership withH.E.Dr. AUXILLIA MNANGAGWA, The First Lady of Zimbabwe and the Ambassador of Merck Foundation More Than a Mothertogether withMinistry of Health & Child Care, at the State House of Zimbabwe, the programs which started in 2019 aim to transform patient care, build healthcare capacity, break the stigma of infertility, empower women, support girl education in Zimbabwe and the rest of Africa.Senator, Dr. Rasha Kelej, CEO of Merck Foundation and President of More Than a Mother Campaignemphasized, I am honored to meet my dear sister,H.E. Dr. AUXILLIA MNANGAGWA, The First Lady of Zimbabwe and the Ambassador of Merck Foundation More Than a Motherat the State House of Zimbabwe for the first time in the country, to officially launch our programs and follow up our long-term partnership to build healthcare capacity, support girl education, and empower infertile women in Zimbabwe.

I am proud to share that together withZimbabwe First Lady, we have provided around100 scholarshipsof one-year Diploma and two-year Master Degree in many critical and underserved medical specialties including Fertility & Embryology, Oncology, Diabetes, Preventive Cardiovascular, Endocrinology, Sexual & Reproductive Medicine, Respiratory Medicine, Acute Medicine, and Clinical Microbiology, infectious diseases and more to young Zimbabwean doctors.

H.E. Dr. AUXILLIA MNANGAGWA, The First Lady of Zimbabwe and Ambassador of Merck Foundation More than a Motherexpressed, I am very happy to meet and host Merck Foundation CEO for the first time in our country especially after the corona pandemic slightly eased. We started our joint programs in 2019 and are happy to officially launch these important programs, and also celebrate an important milestone of success and impact. We worked hard together with Merck Foundation over the past three years to make history by providing specialty training to first specialists in many fields in public sector hence transforming patent care landscape in our country.

Moreover, during the launch program, Merck Foundation CEOtogether withZimbabwe First Ladymet and acknowledged the Merck Foundation Alumni and the Winners of the Merck Foundation Media Recognition Awards.Senator Rasha Kelejfurther emphasized, It was lovely meeting and acknowledging our Merck Foundation Alumni who are the future healthcare experts of Zimbabwe. It was also a pleasure to felicitate the Winners of 2019, 2020 and 2021 Merck Foundation Media Awards from Zimbabwe and discuss with them the critical role they can play to create a culture shift and to be the voice of the voiceless to be Merck foundation health and social champions.

Zimbabwe winners of Merck Foundation Media Awards in partnership withThe First Lady of Zimbabwe, H.E. Dr. AUXILLIA MNANGAGWA & Ambassador of Merck Foundation More Than a Motherare:

Merck Foundation "More Than a Mother" Media Recognition Awards 2021

Moses Mugugunyeki,The Standard (Print FIRST Position)

Tendai Rupapa,The Herald (Online FIRST Position)

John Manzongo,The Herald (Online FIRST Position)

Gracious Mugovera,The Patriot (Online FIRST Position)

Catherine Murombedzi nee Mwauyakufa, The Observer (Online SECOND Position)

Merck Foundation "Mask Up with Care" Media Recognition Awards 2021

Silence Mugadzaweta,NewsD (Print SECOND Position)

Muchaneta Chimuka,Zimpapers Covid-19 Newsletter (Online FIRST Position)

Tendai Rupapa,The Herald (Online FIRST Position)

Nevson Mpofu,www.panafricanvisions.com (Online SECOND Position)

Elizabeth Sitotombe,The Patriot Newspaper (Online SECOND Position)

Silence Mugadzaweta,News Day (Online THIRD Position)

Veronica Gwaze,Sunday Mail (Online THIRD Position)

PETER CHIVHIMA,ZIMBABWE BROADCASTING CORPORATION (MULTIMEDIA FIRST Position)

Merck Foundation "More Than a Mother" Media Recognition Awards 2020

Roselyne Sachiti,The Herald Newspaper (Print - FIRST Position)

Mugugunye Moses,The Standard (Print SECOND Position)

Patrick Musira,The Afronews (Print -THIRD Position)

Takudzwa Chihambakwe,Zimpapers Group (Print - THIRD Position)

Nyasha Clementine Rwodzi ,Self Represented (Print SPECIAL AWARD, NOVEL)

Gracious Mugovera,The Patriot (Online FIRST Position)

John Manzongo,The Herald Newspaper (Online THIRD Position)

Abel Dzobo,Hela TV (Multimedia - FIRST Position)

Tashie Masawi,ZBC Radio Station Classic 263 (Radio - FIRST Position)

Rutendo Makuti,ZBC Radio Zimbabwe (Radio - SECOND Position)

Memory Nkwe Ndhlovu,Media House: Classic 263 (Radio - THIRD Position)

Merck Foundation "Stay At Home" Media Recognition Awards 2020

Bridget Mananavire, Independent Senior Reporter (Print - SECOND Position)

Cliff Chiduku, Newsday (Print - THIRD Position)

Tendai Rupapa,The Herald (Online FIRST Position)

Andrew Mambondiyani, The African Argument (Online - SECOND Position)

Merck Foundation "More Than a Mother" Media Recognition Awards 2019

Abel Dzobo,Hela TV (Multimedia)

John Manzongo,The Herald Newspaper (Online)

Mugugunye Moses Chigwa,The Standard (Print)

Patrick Musira,The Afronews, Canada (Print SPECIAL)

Roselyne Sachiti,The Herald Newspaper (Print SPECIAL)

Takudzwa Chihambakwe, Zimpapers Group (Print SPECIAL)

Tashie Masawi, ZBC Radio Station Classic 263 (Radio)

Rutendo Makuti,ZBC Radio Zimbabwe (Radio SPECIAL)

During the coronavirus outbreak, Merck Foundation also supported the livelihood of women and casual workers families, the most affected by coronavirus lockdown through community donation.

Moreover, Merck Foundation in partnership withThe First Lady of Zimbabwetogetherwith Ministries of Health and Informationhad organized their Health Media Training to educate the media to raise awareness about breaking the infertility stigma and other critical social and health issues in Zimbabwe and the rest of Africa.A new edition of the Health Media Training will be organized soon.

Merck Foundation CEO also announced the Call for Applications for 2022 in partnership withZimbabwe First Lady, for their 8 important awards for Zimbabwean Media, Musicians, Fashion Designers, Filmmakers, students, and new potential talents in these fields.

The awards announced are:1.Merck Foundation Africa Media Recognition Awards More Than a Mother 2022Clickhereto view more details.2.Merck Foundation Film Awards More Than a Mother 2022Clickhereto view more details.3.Merck Foundation Fashion Awards More Than a Mother 2022Clickhereto view more details.4.Merck Foundation Song Awards More Than a Mother 2022Clickhereto view more details.5. Merck Foundation Media Recognition Awards 2022 Diabetes & HypertensionClickhereto view more details.6. Merck Foundation Film Awards 2022 Diabetes & HypertensionClickhereto view more details.7.Merck Foundation Fashion Awards 2022 Diabetes & HypertensionClickhereto view more details.8.Merck Foundation Song Awards 2022 Diabetes & HypertensionClickhereto view more details.

Submission deadline: 30thOctober 2022.Entries are to be submitted tosubmit@merck-foundation.com.About Merck Foundation More Than a Mother campaignMerck Foundation More Than a Mother is a strong movement that aims to empower infertile women through access to information, education and change of mind-set. This powerful campaign supports in defining policies and interventions to build quality and equitable Reproductive and Fertility Care Capacity, Break Infertility Stigma and Raise Awareness about Infertility Prevention and Male Infertility.In partnership with African First Ladies, Ministries of Health, Information, Education & Gender, academia, policymakers, International fertility societies, media and art, the initiative also provides training for Fertility Specialists and Embryologists to build and advance fertility care capacity in Africa and developing countries.With Merck Foundation More Than a Mother, we have initiated a cultural shift to de-stigmatize infertility at all levels: By improving awareness, training local experts in the fields of fertility care and media, building advocacy in cooperation with African First Ladies and women leaders and by supporting childless women in starting their own small businesses. Its all about giving every woman the respect and the help she deserves to live a fulfilling life, with or without a child.The Ambassadors of Merck Foundation More Than a Mother are:

H.E. NEO JANE MASISI, The First Lady of Botswana

H.E. REBECCA AKUFO-ADDO, The First Lady of Ghana

H.E. AISHA BUHARI, The First Lady of Nigeria

H.E. ANGELINE NDAYISHIMIYE, The First Lady of Burundi

H.E. CLAR WEAH, The First Lady of Liberia

H.E FATIMA MAADA BIO, The First Lady of Sierra Leone

H.E. BRIGITTE TOUADERA, The First Lady of Central African Republic

H.E. MONICA CHAKWERA, The First Lady of Malawi

H.E. MUTINTA HICHILEMA, The First Lady of Zambia

H.E. ANTOINETTE SASSOU-NGUESSO, The First Lady of Congo Brazzaville

H.E. ISAURA FERRO NYUSI, The First Lady of Mozambique

H.E. AUXILLIA MNANGAGWA, The First Lady of Zimbabwe

H.E. DENISE NYAKERU TSHISEKEDI, THE First Lady of Democratic Republic of Congo

H.E. MONICA GEINGOS, The First Lady of Namibia

H.E. FATOUMATTA BAH-BARROW, The First Lady of The Gambia

H.E. BAZOUM HADIZA MABROUK, The First Lady of Niger

The Former First Lady of Burundi, H.E DENISE NKURUNZIZA, The Former First Lady of Chad, H.E. HINDA DBY ITNO, The Former First Lady of Guinea Conakry, H.E. COND DJENE, The Former First Lady of Malawi, H.E. PROFESSOR GERTRUDE MUTHARIKA, The Former First Lady of Niger, H.E ASSATA ISSOUFOU MAHAMADOU and The Former First Lady of Zambia, H.E. ESTHER LUNGU have worked successfully with Merck Foundation as Merck Foundation More Than a Mother Ambassadors to break the stigma of infertility and empower infertile women in their countries.

Merck Foundation launched new innovative initiatives to sensitize local communities about infertility prevention, male infertility with the aim to break the stigma of infertility and empowering infertile women as part of Merck Foundation More than a Mother COMMUNITY AWARENESS CAMPAIGN, such as;

Merck Foundation More than a Mother Africa Media Recognition Awards and Health Media Training

Merck Foundation More than a Mother Fashion Awards

Merck Foundation More than a Mother Film Awards

Merck Foundation More than a Mother Song Awards

Local songs with local artists to address the cultural perception of infertility and how to change it

Children storybook, localized for each country

Click on the link below to download Merck Foundation Apphttps://www.merck-foundation.com/MF_StoreRedirection

Join the conversation on oursocial media platforms below and let yourvoice be heardFacebook:Merck FoundationTwitter:@MerckfoundationYouTube:MerckFoundationInstagram:Merck FoundationFlickr:Merck FoundationWebsite:www.merck-foundation.comAbout Merck FoundationThe Merck Foundation, established in 2017, is the philanthropic arm of Merck KGaA Germany, aims to improve the health and wellbeing of people and advance their lives through science and technology. Our efforts are primarily focused on improving access to quality & equitable healthcare solutions in underserved communities, building healthcare and scientific research capacity and empowering people in STEM (Science, Technology, Engineering, and Mathematics) with a special focus on women and youth. All Merck Foundation press releases are distributed by e-mail at the same time they become available on the Merck Foundation Website. Please visitwww.merck-foundation.comto read more. To know more, reach out to our social media:Merck Foundation;Facebook,Twitter,Instagram, YouTubeandFlickr.

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Senator, Dr Rasha Kelej, CEO of Merck Foundation with H.E. Dr. AUXILLIA MNANGAGWA, The First Lady of Zimbabwe and the Ambassador of Merck Foundation More Than a Mother

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Merck Foundation CEO Acknowledged Zimbabwe First Lady's Efforts as Ambassador of More than a Mother to Build Healthcare Capacity, Break Infertility S...

Pig Development – Embryology – UNSW Sites

Introduction

Pig (Sus scrofa) developmental model is studied extensively due to the commercial applications of pigs for meat production and for health issues such as obesity, cardiovascular disease, and organ transplantation (xenotransplantation).

Historically, there is an excellent description of the pig reproductive estrous cycle and the cyclic changes that occur within the ovary.[1]

This table allows an automated computer search of the external PubMed database using the listed "Search term" text link.

References listed on the rest of the content page and the associated discussion page (listed under the publication year sub-headings) do include some editorial selection based upon both relevance and availability.

More? References | Discussion Page | Journal Searches | 2019 References | 2020 References

Search term: Pig Embryology | Pig Development

See also the Discussion Page for other references listed by year and References on this current page.

Taxonomy ID: 9823

Genbank common name: pig

Inherited blast name: even-toed ungulates

Rank: species

Genetic code: Translation table 1 (Standard)

Mitochondrial genetic code: Translation table 2 (Vertebrate Mitochondrial)

Other names: wild boar, swine, pigs

Lineage (full): cellular organisms; Eukaryota; Fungi/Metazoa group; Metazoa; Eumetazoa; Bilateria; Coelomata; Deuterostomia; Chordata; Craniata; Vertebrata; Gnathostomata; Teleostomi; Euteleostomi; Sarcopterygii; Tetrapoda; Amniota; Mammalia; Theria; Eutheria; Laurasiatheria; Cetartiodactyla; Suina; Suidae; Sus

Table data - Otis and Brent (1954)[8]

The images below are from the 1897 Normentafeln zur Entwicklungsgeschichte der Wirbeltiere - Sus scrofa domesticus (Normal Plates of the Development of the Pig Embryo) by Franz Keibel

Diagram showing form and dimensions of the uterus and Fallopian tubes of the sow.[1] Drawn from an average specimen taken from a young mature animal.

Female pig is called a sow.

Events of the average cycle of 21 days in the non-pregnant sow.[1]

Diagram showing relationship between oestrua, ovulation, corpus luteum development, and the progress of the ova in the sow.

Events of the first weeks of pregnancy.[1]

Diagram showing relationship between oestrua, ovulation, corpus luteum development, and the progress of the ova in the sow.

Scanning electron microscope images of the endometrial surface of a Day 13 pregnant sow.[9]

Male pig is called a boar.

Capacitation alters the ultrastructure of the apical head and the acrosome of boar sperm.[6]

Model for capacitation-induced stable docking of the acrosome to the sperm plasma membrane.[6]

The testis of the pig receives its first blood supply when the embryo is 33 mm in length.[10]

The data below is summarised from an excellent study of early neural development in the pig.[11] The same authors have studied neural development in the rabbit.

anterior neuropore

22 somite embryo - anterior neuropore is completely closed. (closure sites for the anterior neuropore in mouse embryo, none of these were detected in the pig embryo)

posterior neuropore

8-20 somite embryos - the width of the posterior neuropore does not change, while the rate of closure gradually increases.

Plates below are from a 1916 thesis on palate development in the pig.[12]

Fig. 2. Ventral view of the roof of the primitive mouth of the 17 mm. embryo.

Fig. 3. Ventral view of the roof of the primitive mouth of the 20 mm. embryo.

Fig.4. Ventral view of the roof of the primitive mouth of the 25 mm. embryo.

Fig. 5. Ventral View of the roof of the primitive mouth of the 27 mm. embryo.

Fig. 6. Ventral view of the roof of the secondary mouth of the 50 mm. embryo.

Fig. 7. Ventral view of the roof of the secondary mouth of the 39 mm. embryo.

Fig. 8. Ventral View of the roof of the secondary mouth of the 70 mm. embryo.

Fig. 10. Cross-section of the head of the 12 mm. embryo posterior fig. 9, showing the union of the processes on one side and the blind sac on the other.

Fig. 11. Cross-section through the head of a 17 mm. embryo showing primitive choanae.

Fig. 12. Cross~section through the anterior region of the head of a 27 mm embryo showing the shorter palatal processes.

Fig. 13. Cross-section through the head of a 27 mm. embryo posterior to fig. 12, to show the processes longer in this middle region.

Fig. 14. Cross-section of the head of the 50 mm. embryo, showing the anterior communication of the nasal and mouth cavities.

Fig. 15. Cross-section through the head of the 30 mm. embryo, posterior to fig. 14, to show the fusion of the processes, the slight indication of the invasion of mesemchyme and the fusion of the processes with the nasal septum.

Fig. 16. Cross-section through the head of the 30 mm. embryo in the posterior region to show the ventral separation.

Fig. 17. Cross-section of the 39 mm. embryo cut slightly oblique, showing on one side the respiratory duct cut off,on the other, the connexion with the respiratory cavity.

Miniature Pig Palate Timeline[2]

Arrangement of lymphatic vessels in 40 mm embryo

Lymphatic vessel network in embryo skin. A 18 mm; B 20 mm; C 30 mm; D 40 mm

Transverse section spinal cord 20 cm embryo

Wall of uterus and chorion

Transverse section of umbilical cord of a pig embryo six inches in length

Recent References

Buddington RK, Sangild PT, Hance B, Huang EY & Black DD. (2012). Prenatal gastrointestinal development in the pig and responses after preterm birth. J. Anim. Sci. , 90 Suppl 4, 290-8. PMID: 23365359 DOI.

Somfai T, Kikuchi K & Nagai T. (2012). Factors affecting cryopreservation of porcine oocytes. J. Reprod. Dev. , 58, 17-24. PMID: 22450280

Ostrup E, Hyttel P & Ostrup O. (2011). Embryo-maternal communication: signalling before and during placentation in cattle and pig. Reprod. Fertil. Dev. , 23, 964-75. PMID: 22127002 DOI.

Waclawik A. (2011). Novel insights into the mechanisms of pregnancy establishment: regulation of prostaglandin synthesis and signaling in the pig. Reproduction , 142, 389-99. PMID: 21677026 DOI.

Robison OW. (1976). Growth patterns in swine. J. Anim. Sci. , 42, 1024-35. PMID: 770410

Book SA & Bustad LK. (1974). The fetal and neonatal pig in biomedical research. J. Anim. Sci. , 38, 997-1002. PMID: 4596894

Moor RM. (1968). Foetal homeostasis: conceptus-ovary endocrine balance. Proc. R. Soc. Med. , 61, 1217-26. PMID: 4973146

Moor RM. (1968). Effect of embryo on corpus luteum function. J. Anim. Sci. , 27 Suppl 1, 97-118. PMID: 4951167

Zhang L, Lin Z, Bi Y, Zheng X, Xiao H & Hua Z. (2018). CO2 concentration affects in vitro pig embryo developmental capacity. Pol J Vet Sci , 21, 609-614. PMID: 30468346 DOI.

Liu J, Zhu Y, Luo GZ, Wang X, Yue Y, Wang X, Zong X, Chen K, Yin H, Fu Y, Han D, Wang Y, Chen D & He C. (2016). Abundant DNA 6mA methylation during early embryogenesis of zebrafish and pig. Nat Commun , 7, 13052. PMID: 27713410 DOI.

Hassoun R, Schwartz P, Rath D, Viebahn C & Mnner J. (2010). Germ layer differentiation during early hindgut and cloaca formation in rabbit and pig embryos. J. Anat. , 217, 665-78. PMID: 20874819 DOI.

Search Pubmed: pig development | pig embryo | Sus scrofa development

External Links Notice - The dynamic nature of the internet may mean that some of these listed links may no longer function. If the link no longer works search the web with the link text or name. Links to any external commercial sites are provided for information purposes only and should never be considered an endorsement. UNSW Embryology is provided as an educational resource with no clinical information or commercial affiliation.

Cite this page: Hill, M.A. (2022, August 16) Embryology Pig Development. Retrieved from https://embryology.med.unsw.edu.au/embryology/index.php/Pig_Development

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Pig Development - Embryology - UNSW Sites

Master of Clinical Embryology – Study at Monash University

The Intensive Master of Clinical Embryology is internationally renowned as a training program for all assisted reproductive technologies (ART), producing high calibre embryologists. On completion of this course, you will have developed the specialised knowledge and practical skills needed to work in, and manage, human ART clinics.

The course is offered both on-campus (one year full time) and off-campus (restricted entry, full or part-time) to domestic and international students.

Your studies will include the foundations of mammalian embryology, detailed assessment of all infertility treatment strategies and the theoretical basis behind embryo production, embryo selection and cryopreservation, with a focus on all current and future technologies associated with ART. You will also study units dedicated to Total Quality Management, Preimplantation Diagnosis and Ethics.

Throughout the course you will acquire all the practical skills required of andrologists and embryologists, from sperm and embryo handling and assessment, to in vitro fertilisation techniques and cryopreservation techniques, including vitrification of gametes and embryos. You will finish the year learning ICSI and biopsy procedures.

While learning the practical skills, you are also given opportunities to visit ART clinics and attend ART industry conferences within Australia and internationally. You will engage in research projects that are designed to enhance your practical and research skills, while assessments throughout the year are designed to measure your competency in theoretical, practical and research disciplines.

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Master of Clinical Embryology - Study at Monash University

Letter: The inconvenient science of embryology – INFORUM

In a recent letter, " How to keep abortion legal ," the writer stated that fetuses in their first 12 weeks ... have zero brain function and do not respond to stimuli of any kind. In another letter, " The war on women is escalating ," the writer refers to the unborn human life as a blob of protoplasm. Whether these statements of blatant misinformation were intentional, or simply from an extreme lack of knowledge, they certainly need to be corrected.

The scientific facts are that at just 3 weeks from conception (approximately 5 weeks gestational age) the first signs of brain development are evident, and by 4 weeks from fertilization the basic structure for the entire central nervous system has formed. At 8 weeks the babys brain is growing rapidly, producing almost 250,000 new neurons each minute. At this point the embryo can respond to touch by reflex and the brain can make the muscles move on purpose.

By 9 weeks from fertilization the baby has all of the major organ systems and is a distinctly recognizable human being now known as a fetus, a Latin word for young one. The heart was the first organ to function by the third week (18-21 days) from fertilization. By the fourth week it can be observed on an ultrasound scan beating about 80 times a minute. In addition, by this time the eyes are developing, and the arm and leg buds are visible. Also, keep in mind that from the very moment of conception all the genetic information for every detail of this newly created and unique life is present.

All of the above facts refer to the developing human being in its first 12 weeks from conception, the time when most abortions are done. These scientific facts of embryology come from a number of sources including embryology textbooks, National Geographic, the Mayo Foundation for Medical Education and Research, and other sources too numerous to mention in the space allowed here.

While we are always told to follow the science, apparently when it comes to abortion we are instead expected to disregard this inconvenient science of embryology completely. In a recent documentary movie The Matter Of Life, Dr. Anthony Levatino, an OB GYN specialist who had performed over 1,200 abortions, stated that one day during a routine abortion his clamp pulled out an arm and a leg and it finally hit him that this was someones son or daughter. He got sick and never did another abortion again. He also stated that It doesnt matter what size the unborn baby is - its the same human life! Dr. Levatino is right. Human life of any age is human life and should be protected as such. And, as these little ones cannot protect themselves, it is up to us to do so.

Dr. Bernard Nathanson, another former abortionist, who became pro-life after watching the unborn baby on an ultrasound during an abortion concluded the documentary by stating: Lets all, for humanity sake, stop the killing! Yes indeed, let us!

Ken Koehler lives in West Fargo.

This letter does not necessarily reflect the opinion of The Forum's editorial board nor Forum ownership.

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Letter: The inconvenient science of embryology - INFORUM

Letters to the Editor August 13, 2022 | The Citizen – Ortonville Citizen

What is pro life?Shouldnt government deciding to end abortions understand embryology? Long term consequences? Responsibility forbothparents?Most seeking abortion for reasons other than medical issues do so in the first trimester, when the fetus is not viable and there is no brain. It takes 28 weeks until the embryo senses touch , hearing and smell. Do those who are against abortion consider taking a brain dead person off of life support murder?The person half (or more) responsible for the pregnancy is never mentioned in the anti-abortion laws. If we care about the unborn child arent both parents responsible? Why is it not mandatory we all provide our DNA to be registered in an international data bank, so that both mother and father pay their share in the cost of pregnancy (health care, loss of wages etc) and in the upbringing of the child?If those against abortion care about life, could we then also use such registry to harvest an organ for a child that needs one , where we can live without one ?Should we make it mandatory to adopt an unwanted child before we create our own?If we force fetuses being diagnosed with chromosomal or other abnormalities to be born, should we not first have the resources to take care of those children after being born ? And after their parents are no longer there to help them through life? All the parents of such children I know are struggling as this country is not willing to take care of that issue.If you consider life to end with the last breath, would then life start at first breath?Anita BakkerOrtonville

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Letters to the Editor August 13, 2022 | The Citizen - Ortonville Citizen

Scientists Are Learning How to Help Coral Reefs Save Themselves – AAAS

Cody Clements never saw the eel coming. The marine ecologist was collecting corals for an experiment in shallow waters off the island of Mo'orea, French Polynesia, when a six- to seven-foot moray eel shot out from a crevice in the reef. Before Clements could react, the creature sank its teeth into his hand and began yanking it around like a rag doll.

The eel released Clements' hand from its powerful jaws, but he quickly realized his ordeal was just beginning.

"My thumb was, like, dangling off," he said. "It was pretty bad. To be honest, in the moment I thought I might bleed to death."

Thinking quickly, Clements used his rash guard as a tourniquet while he rushed to shore. But preventing blood loss was no easy task. Moray eels, which rarely attack humans, have backwards-jutting teeth and toxic mucus that cause notoriously painful, bloody wounds. Fortunately, Clements made it back to shore and was taken to the hospital on Mo'orea, where he received 67 stitches. He underwent surgery in Tahiti the next day. Ten weeks later, the scientist had a scar extending the length of his palm, but he could finally move his thumb again.

Moray eel. | David Clode/Unsplash

Before he suddenly found himself grappling with the question of his own survival on the reef, Clements, a postdoctoral fellow at the Georgia Institute of Technology, was puzzling over a matter of life-or-death for reefs themselves how does the diversity of coral species impact a reef's survival and productivity?

"Other people have tested how coral diversity impacts the number and diversity of local fish communities and things of that nature," said Clements. "But, 'How does biodiversity of corals impact corals?' That was a fairly novel question."

As climate change warms the world's oceans to ever-higher extremes, coral reefs face a bleak future. A 2021 report found that 14% of the world's reefs died due to rising ocean temperatures between 2008 and 2019.

As the situation grows more dire, researchers like Clements are going the extra mile to understand what makes corals tick. By learning how corals survive under different conditions and why some seem to be hardier than others, scientists may be able to assist corals in their battle against extinction.

These research efforts are as varied as the corals themselves. Some scientists are investigating how corals function as communities while others are hunting for specially adapted "super reefs." Still others are selectively breeding corals in the lab or applying biomedical techniques to understand the genetic basis of heat tolerance.

But while playing to corals' strengths may make some difference in helping these vital ecosystems withstand climate change, scientists urge that these efforts be paired with curbing emissions.

To investigate the impact of coral diversity on coral communities, Clements leveraged a method of planting corals that he had recently developed, which involved planting corals in Coke bottles.

"I can just screw them in and then unscrew them and weigh them," he said. "It's an easy way to manipulate them."

Building on this technique, Clements assembled what he calls "chess boards" Coke bottles with sawed-off necks embedded in cement blocks (the chess board squares), with corals planted in each bottle. To sufficiently replicate different levels of community diversity for an October 2021Science Advances paper published with Mark Hay, a professor in the school of biological sciences at Georgia Tech and an associate editor at Science Advances, Clements assembled 48 chess boards, each with 18 corals. The chess boards were assembled at random from a pool of nine coral species, with plots containing either one, three, six, or nine different species.

Clements' "chess board" coral experiments. | Cody Clements

The researchers found that corals performed better in more diverse communities at least, to an extent. Their performance peaked with three to six species, then declined again as the number of species per chess board rose to nine.

"We're still trying to chase down the mechanisms, but my pet hypothesis is that when you have multiple species present, it potentially helps dilute disease," said Clements. "I was seeing in some of my single species plots that a coral would start to get sick and then [the disease] would start spreading in the community. That also goes on in agriculture. There's evidence that if you have mixed-species crops and a disease comes through, [the crop diversity] is going to create barriers for transmission."

Clements noted that while these findings are encouraging, it is still difficult to know how findings about the benefits of diverse coral communities may benefit corals beyond his chess boards.

"We're testing the basic scientific notion, but extrapolating that up to how we're going to use it to rehabilitate reefs is much harder. I picked those nine species because they are some of the most common ones I see. But you don't ever really see that many species in an area as small as the 40 by 40-centimeter experimental coral plots that we created for our experiment."

"We're working from a shifted baseline, going out and looking at a reef that's really degraded now," he added. "But it might not have been like that in the past."

When Hannah Barkley was a graduate student, she and her colleagues discovered that some reefs have superpowers.

At the time, Barkley, now a Hawai'i-based research marine biologist with the National Oceanic and Atmospheric Administration, was working with coral researcher Anne Cohen, who runs a lab at the Woods Hole Oceanographic Institution in Falmouth, Massachusetts. Researchers at Cohen's lab were interested in understanding how reefs respond to ocean acidification especially ways in which some reefs show resilience to this major threat to coral ecosystems. As an ocean absorbs carbon dioxide released into the atmosphere from fossil fuel-emitting activities, its pH falls, resulting in fewer calcium minerals that coral reefs need to build and repair their skeletons, slowing their growth.

"The problem is that identifying resilience to ocean acidification is really challenging," said Barkley. "Most of what we know about ocean acidification has come from controlled laboratory studies. But laboratory conditions and laboratory responses don't always play out as we might predict in a real-life field setting."

To overcome the limitations of lab studies, Barkley said coral researchers have turned their attention to ocean locations where natural processes produce low pH conditions in the wild.

"None of these sites are perfect analogues for ocean acidification," Barkley said. "But when we look at them together, they can tell us something about how reefs might respond to pH changes in the future and what the most sensitive responses are to ocean acidification."

Among these sites are the Rock Islands of Palau, an archipelago of over 500 islands in the western Pacific. Coral reef environments in the area have an average pH of only 7.8, while most other reefs currently have pHs of about 8 to 8.1 a result of the long time the water lingers in the bays as it winds around labyrinthine rock, gradually growing more acidic.

"The Rock Islands are special because they currently experience predicted end-of-century conditions, both in terms of temperature and pH," said Barkley, referring to ocean heat and acidity projections for the end of the 21st century. "They have very low pH and very high temperature."

For a study published in Science Advances in 2015, Barkley and colleagues traveled to Palau to observe reefs on the archipelago. They found that the low-pH Rock Island reefs had the highest coral cover and coral diversity of any of the reefs they studied on Palau, even those living at high pH levels, where the researchers would have expected corals to do better.

In contrast to most laboratory results preceding the study, the team also found that low pH didn't inhibit the corals' growth they grew as fast in low-pH conditions as they did at high-pH conditions. The only downside to decreasing pH that Barkley and colleagues observed for corals in Palau was increasing rates of bioerosion, when organisms like mollusks or bivalves eat away at the coral skeleton.

"This result was really exciting because it was the first time that anyone in the coral reef community observed coral reefs that were not only surviving end-of-century pH conditions, but actually appeared to be thriving. Since then, we've seen other examples and other places with corals that share similar adaptive capacities," she said.

The Cohen Lab has uncovered such " super reefs" in the Dongsha Atoll of the South China Sea, Racha Noi, Thailand, and Kanton Island of the Phoenix Islands in the Republic of Kiribati.

Low pH coral reef in Palau. | Hannah Barkley

Barkley is quick to note that the study's findings don't imply that corals are off the hook when it comes to surviving increasingly acidic waters.

"Ocean acidification is still a threat to coral reefs," she said. "But we do see these unique places like Palau, where there are special coral reef communities that over the hundreds of thousands of years they've been exposed to low pH, have figured out how to deal with low-pH conditions. However, most reefs won't have the luxury of that long timeframe due to the rate of progressive ocean acidification over the century."

In a follow-up to the Palau study, Barkley and colleagues conducted a laboratory experiment in which they took corals from the low-pH sites on their trip and corals from the high-pH sites and put them in different pH conditions. These included ambient pH conditions on the high-pH reef, ambient conditions on the low-pH reef (the conditions they expect most reefs will see by the end of the century), as well as pHs that were lower than most reefs were expected to experience. They found that the low-pH corals remained healthy and continued to grow at the same rate regardless of what pH they were made to endure.

"This is important because it suggests that they're not only surviving now, but have the potential to withstand further decreases in pH in the future," said Barkley.

The researchers also conducted a habitat-swapping experiment in which they moved corals from a low-pH Palau reef to a high-pH reef and vice-versa, then observed them over 17 months.

"The transplants all died, which was not the result we expected," said Barkley.

"But I don't think this means that these corals can't ultimately seed populations or be the source of coral transplants to other areas," she added. "I think it means the answer is not that simple and that pH is one of many environmental variables that differ between various sites. Corals are so supremely adapted to the specific environment in which they live that it is not just a question of pH in terms of their ability to survive elsewhere."

In May 2022, Emily Howells found herself with a front row seat to watch a massive bleaching event unfold at the Great Barrier Reef a process in which corals expel their algae under stressful conditions, turning them white and causing many to starve. It was the kind of event that would have been almost unheard of during La Nia years in the past, when temperatures are generally cooler and wetter. But Howells knows firsthand how fast the reef is changing.

"From my own observations, I can report that I've observed bleaching each year I've been out working on the Great Barrier Reef for the past few years," she said. "And that's not something I have seen, say, when I was a Ph.D. student."

Rapid heat stress experiments test coral thermal tolerance. | AIMS/ Jo Hurford

Howells is a coral biologist at Southern Cross University in Australia, where she studies the genetic basis of coral heat tolerance. Howells also works with the Reef Restoration and Adaptation Program, measuring variation in heat tolerance among individual corals across the Great Barrier Reef.

"We have a couple of focal coral species and we are sampling up to a thousand corals of those species," said Howells. "We measure and rank their heat tolerance in a rapid heat stress experiment, and then see how much of the variation in heat tolerance among individuals can be explained by their genes."

While Howells admitted it is still too soon to identify the roles different genes play in corals' abilities to tolerate higher temperatures, her team's early research results show that there is a lot of variation in heat tolerance among individuals. The reasons behind this variation are bound to be complicated.

"There are many genes and variants that contribute to the heat tolerance of corals," she said. When Howells began receiving reports from other colleagues about signs of bleaching on the Great Barrier Reef, she and her team went back to one of their research sites in an affected area to see how the corals they had tagged (each with their own GPS identifier) were holding up. While Howells found that most corals had probably experienced some bleaching, she noticed plenty of variation.

"We saw some that were severely bleached, kind of a glowing white color, and others that were living side by side that seemed to be doing okay," she said. "We look forward to kind of incorporating those observations in our understanding of the genetic basis of heat tolerance in corals and seeing if they share the same genetic variants as corals that we've identified as being heat tolerant in previous experiments."

When Howells was a postdoc, she spent time doing research at New York University Abu Dhabi, a campus located in the capital of the United Arab Emirates, which rests on an island off the mainland in the Persian Gulf. Compared to most bodies of water that support tropical coral reefs, the gulf is sweltering 36C (96.8F) or 37C (98.6F) in the summer.

To discover whether it was possible to transfer the genetic variants that gave the Persian Gulf corals their heat tolerance into the offspring of less-heat tolerant populations, Howells collected fragments of coral colonies from the reef and brought them to the university's lab. Next, she ventured to a reef on the Indian Ocean side of the United Arab Emirates, where temperatures are cooler, and collected fragments of the same coral species. Once she had gathered all of the specimens together, Howells waited patiently night after night for the corals to spawn.

Persian Gulf Platygyra coral spawning. | Anna Scott

At last, Howells and her colleagues succeeded in breeding 50 families of coral larvae some with both parents from the same region and others with fathers from Abu Dhabi and mothers from the Indian Ocean.

The findings, which were published in Science Advances in August 2021, revealed that selective breeding of corals from an Indian Ocean population with heat-adapted fathers from the Persian Gulf increased the thermal tolerance of offspring to the same level as those with both parents from the Persian Gulf.

"I thought that we would see some gain in heat tolerance, but I didn't think that it would be as high as what we saw," said Howells. "That was really a strong demonstration that heat tolerance is genetically determined and can be passed on to other populations [by selective breeding]."

Before Philip Cleves turned his attention to corals, his focus was biomedicine.

"It was always kind of the plan," he said. "When I was an undergrad, my 'aha' moment was when I learned that corals have algae that live inside their cells, undergo photosynthesis, and feed the corals. To me, as a young scientist, I was completely blown away by that."

Today, Cleves runs a lab at the department of embryology at the Carnegie Institution for Science in Baltimore, Maryland, where, like Howells, he works to understand the basis of resilience to heat stress in corals.

"What we're doing in my lab now is trying to apply biomedical techniques to corals, to better understand their genetics and molecular biology in order to better prevent and ameliorate the effects of climate on these ecosystems," said Cleves. "Just like it's important to understand the molecular basis of human diseases, we think that if we understand the molecular basis of coral biology we can better predict and make therapeutics to help preserve corals, just like we do for human diseases."

Cleves pointed out that even though coral reefs are being wiped out an unnerving rate 30% of the Great Barrier Reef was destroyed during a 2016 heat wave scientists actually don't know much about how corals work at the genetic level.

"The reason we know so little is because corals are really hard to study in the lab and we didn't have genetic tools like we have in other systems to really understand the genes involved," he said.

In recent years, Cleves has helped to overcome this barrier by developing and applying CRISPR/Cas9 genome-editing technology to coral specimens from the Great Barrier Reef. "In the short term, what we're really excited about using CRISPR for is to be able to ask, really for the first time ever, 'what do genes do in coral?'" said Cleves. "We've been able to characterize some genes as master regulators of the coral heat stress response. So we have some clues as to the types of genes that protect corals from heat stress, and we're interested in developing these tools to better understand how corals work at the genetic level."

"I think it's mostly us in collaboration with great people around the world using genetic engineering to study corals right now," he added. "I hope there's going to be more attention to it and that the [coral gene editing] method will expand so that we'll really understand what's happening."

Cleves hopes that scientists might eventually be able to find genetic determinants for corals that can withstand future climate scenarios, helping to focus limited conservation efforts on those most likely to withstand the coming changes.

"My dream would be that with a deeper understanding of what genes make corals resilient to climate change, we could go out into the field and use that genetic information," said Cleves. "Wouldn't it be cool to have like a 23andMe for corals? Or you go out and you say, okay, this animal, this animal, this animal these ones have genotypes that make them the corals of the future."

But Cleves' dream does not involve manipulating the genomes of corals in the wild. He limits his genetic engineering efforts to the lab, where he and his team try to make mutations that confer extra resilience on corals. The end game is to find resilient corals that already exist in nature and to propagate these evolutionary winners.

Montipora capitata, one of the coral species in Cleves' study of diagnostic markers of heat stress. | Ryan McMinds

"The idea of making genetically modified coral and releasing it is not really something that we are thinking about because our understanding of genetic information and the genetic basis of coral biology is really in its infancy," said Cleves. "We don't know the genes that could enhance tolerance even if we wanted to do that. Also, there would be a lot of regulatory and ethical considerations about releasing genetically modified corals."

Not all of Cleves' coral research involves gene editing. In a Science Advances paper published in January 2021, Cleves, first author Amanda Williams, and colleagues extracted and analyzed metabolites involved in growth and development from bits of Hawaiian corals that they bleached in a lab to investigate their physiological responses to bleaching. The researchers identified several metabolites that may offer diagnostic markers for heat stress in wild corals.

When it comes to saving coral reefs, Cleves admires scientists' myriad ideas. "There's talk aboutkind of everything," he said. "Assisted gene flow, probiotics, and moving corals from one part of the world to another."

"For all of these conservation efforts, we want to make sure that we're doing the appropriate scientific research to understand that the things that we're trying to do will actually benefit the ecosystems in the long run," he said. "There's nothing that I've seen that I have been particularly nervous about. I think there are a lot of really smart people doing smart things. I'm curious to see what the benefits, if any, of these conservation efforts are."

But ultimately, Cleves is convinced the strategy with the greatest chance of success would be to let corals do what they do best.

"I think the most promising scaling-up for conservation would be the type of scaling-up that led to the existence of the Great Barrier Reef in the first place the fact that animals like reproducing and like growing where it's appropriate for them to grow," he said. "I think the really important thing to do is to meet climate emission targets. The collapse of coral reefs is one of the early, traumatic things that's happening with climate change, and if we don't change our behavior, then that's how it's going to continue. The other things that are predicted will continue to happen."

Howells agreed that promising coral reef conservation strategies have their limitations. Noting that her own research does not focus on implementing interventions, she concluded that selective breeding could potentially make a difference but only for particular species in particular locations.

"You cannot counter the effects of global warming with solutions like this," Howells said. "Restoration efforts can only ever be deployed at a subset of reefs because of cost and logistical constraints. However, what you can do is give certain species a helping hand and target high-value populations."

"We'll try every technique we can to save reefs, but one of the best things to do would just be to stop putting so much carbon in the atmosphere," added Clements. "Otherwise, you're trying to put a Band-Aid on a wound that needs emergency surgery."

[Credit for associated image: Ruby Holmes]

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Scientists Are Learning How to Help Coral Reefs Save Themselves - AAAS

Hypospadias: A Comprehensive Review Including Its Embryology, Etiology and Surgical Techniques – Cureus

Hypospadias is a congenital deformity of the external genitalia in males. It is defined by the aberrant growth of the urethral fold and the ventral foreskin of the penis, which results in the incorrect location of the urethral opening [1]. In hypospadias, the external urethral meatus may be mispositioned to a different degree and may be accompanied by penile curving. Patients could have an extra genitourinary abnormality based on the location of the hypospadias [2,3]. It is considered among the most prevalent congenital abnormalities in males. Hypospadias occurs in one out of 150 to 300 live births [4,5]. After undescended testis, hypospadias is the second most common congenital abnormality [2]. Hypospadias is frequently characterized as posterior, penile, or anterior based on the preoperative location of the meatus. Nearly 70% of hypospadias are glandular or distally placed on the penis and are regarded as moderate variants, while the remaining are more severe and complicated. This classification was suggested by Duckett [6] (Figure 1).

The standards are used to define and evaluate hypospadias. Meatal position alone is widely regarded as a rudimentary method for classifying the severity of hypospadias since it does not consider the degree of tissue abnormality. In addition, the size of the penis, the size of the glans and urethral plate, the amount of separation of the corpus spongiosum, the existence of curvature, as well as abnormalities, and the location of the scrotum, have a substantial impact on the success of surgical correction. Consequently, a definitive classification can only be made following surgery [7].

This review article focuses on describing the embryological defects that cause hypospadias and the clinical characteristics of the condition. Outline the classification of hypospadias, its management options, the timing of surgery, and its results.

When penile growth is halted, it produces the three-fold classic triad of hypospadias, which includes a hooded dorsal foreskin, an inverted penile curvature on the dorsal side of the foreskin, and a proximal urethral meatus.

In the earliest weeks of embryonic development, the abnormal or incomplete closure of the urethra is the primary pathophysiological event that leads to hypospadias. Development of the external genitalia happens in two stages, which for both sexes are identical. In the first phase, which occurs between the fifth and eighth weeks of pregnancy, the primordial genitalia is formed in the absence of a hormonal stimulus. During this phase, mesodermal cells oriented laterally to the cloacal membrane produce the cloacal folds. These folds combine anteriorly to create the genital tubercle (GT), then break posteriorly into the urogenital and anal folds that surround the urogenital sinus. The GT is composed of three cell layers: the lateral plate mesoderm, the surface face ectoderm, and the endodermal urethral epithelium. This is the primary signaling center for GT's development, differentiation, and outgrowth [8].

In men with chromosomes XY, the second phase, a hormone-dependent stage, begins with the development of gonads into testes. Two of the most significant actions of testicular testosterone are the elongation of the GT and the formation of the urethral depression. The urethral plate, the distal section of the urethral groove, is delineated laterally by the urethral pleats and extends into the glans penis. The urethra is generated when the urethral folds merge, and the coat of the penis is created from the outer surface of ectodermal cells, which merge with the ventral part of the phallus to form the median raphe.

Various malformations, including hypospadias, an abnormal curve of the penis, and improper penile foreskin generation, can be caused by genetic disruption or change of signaling pathways in male external genital and urethral development.

Approximately 18.6 out of every 10,000 live births in Europe are affected by hypospadias. Registrations in 23 European registries between 2001 and 2010 demonstrated a steady number despite previously observed increases and decreases in temporal patterns [9]. North America has the highest prevalence, with 34.2 cases per 10,000 live births, whereas Asia has the lowest, at 0.6-69 cases per 10,000 live births. Even with more than 90 million screened newborns, the real global prevalence and trends are still difficult to quantify due to various methodological issues [5].

Given its frequency, hypospadias can place a significant strain on healthcare spending. A significant risk of complications may necessitate many procedures, particularly in the most severe instances. In addition, a substantial proportion of patients struggle with aesthetic or functional issues [2,10].

Concerning the genesis of hypospadias, several explanations have been offered, including genetic susceptibility, insufficient prenatal hormone stimulation, maternal-placental variables, and environmental impacts. Thus, it is plausible that hypospadias has several causes [11]. Premature birth, small-for-gestational-age newborns who are less than the 10th percentile for weight, length, and/or head circumference, and intrauterine growth restriction are risk factors. All of these have been linked to an increased chance of having a baby with hypospadias [12,13] (Table 1). Hypospadias rates have been linked to both inadequate placentas and the use of assisted reproductive technologies [14,15].

One in every seven occurrences of hypospadias is passed down through first, second, or third-degree family members. For anterior and middle forms, familial occurrence appears to be more prevalent than for posterior kinds. It is estimated that between 9 and 17% of the male siblings of a hypospadias-infected kid may get the condition [11]. One-third of hypospadias are directly linked to a genetic abnormality [16]. Nearly 200 disorders with recognized genetic etiology are connected with hypospadias. However, only a percentage of males with idiopathic variants have this condition [17]. The most common associations are WAGR syndrome, Denys-Drash syndrome, and Smith-Lemli-Opitz syndrome [2,18].

Another important factor in hypospadias is hormonal influence. Most hypospadias is solitary conditions, while uni-bilateral cryptorchidism and micropenis are related abnormalities [19]. These co-morbidities indicate a lack of hormonal effects during development. Androgens and estrogens both play a crucial role in genital development, and in the event of an imbalance, a range of congenital penile malformations, including hypospadias, micropenis, and ambiguous genitalia, can be observed [19]. A shortened anogenital distance in males with hypospadias as a consequence of a disturbance in embryonic androgen exposure [20] is a clinical observation that supports this notion. Other studies highlight the possible impact of so-called endocrine-disrupting environmental pollutants on the formation of hypospadias. Hypospadias was created in mouse models by the exposure of their mothers to synthetic estrogens. Due to the enormous variances across animals, it remains disputed whether someone has a significant effect on humans [21].

Hypospadias is among the most prevalent birth defects in males. A misplaced, ventrally-located urethral meatus; a ventral penile curvature; and an imperfect, dorsally-hooded foreskin are the physical exam criteria for diagnosing an ectopic urethral meatus. Hypospadias is a vast concept, however, and the degree of each symptom can vary significantly across boys. The second and third components are not usually present. Up to 5% of boys suffering from hypospadias have an undamaged prepuce, and the condition is not recognized till the foreskin becomes retractable or diminished during circumcision. Since an intact prepuce can conceal the existence of inadequate urethral growth in a newborn infant, it is essential to retract the foreskin before circumcision to prevent losing this oddity and presumably harming the imperfect urethra or expelling foreskin that could be incorporated into a subsequent urethral reconstruction [22].

Initial assessment of males with hypospadias must include a thorough medical history and physical examination. In conjunction with the trio of hypospadias, males may have related abnormalities such as penile torsion, penoscrotal webbing, and penoscrotal displacement, which must be taken into account while planning the surgery. On physical examination, boys with hypospadias may have dysplastic ventral tissue. On examination, a shortage of ventral axis skin may be instantly apparent.

The position of the urethral meatus has traditionally been used to determine the degree of hypospadias [7]. Using these criteria, almost 85% of males have a mild distal meatus variation [23]. Proximal hypospadias occurs in almost 15% of individuals and provides the surgeon with various distinct therapeutic issues [9].

A classification of hypospadias based only on the position of the urethral meatus is very simplistic and may even be deceptive. A classification system that incorporates the position of the urethral opening and the degree of penile curvature following degloving results in a more accurate and pertinent diagnosis.

The GMS score (glans meatus and penile shaft [curvature]) integrates physical exam outcomes in the operating room, evaluating the quality of the glans and urethral plate, the position of the urethral opening, and the degree of penile curvature, to objectively allocate scores for severity stratification (Table 2). The GMS score was designed for use in the operating room since office measures are less reliable in determining severity, namely the extent of ventral penile curvature [24,25].

Inguinal hernia, hydrocele, and cryptorchidism are the malformations most frequently linked with hypospadias. Inguinal hernia and/or hydrocele are up to 16% more prevalent [26]. Approximately 7% of individuals with hypospadias have cryptorchidism. With more proximal hypospadias, this jumps to approximately 10% [27]. Further diagnostic testing is recommended, such as an ultrasound of the urinary system and inner genital organs, to identify other nephro-urological anomalies [28]. Up to 14% of all hypospadias and up to half of the perineal hypospadias have a Mllerian remnant, resulting in catheterization difficulties, urinary blockage, or urinary tract infections (UTIs) following repair [29]. The majority of them are seen by ultrasonography. The American Urology Association cryptorchidism guideline suggests that all boys with unilateral or bilateral undescended testes and severe proximal hypospadias receive further testing to rule out a disorder of sexual differentiation (DSD), which is significantly more common in these situations.

The primary objective of hypospadias treatment is to restore both aesthetic and functional normalcy. Indications for correcting hypospadias comprise spraying of urine stream, inability to pee in a standing posture, curvature causing difficulties during intercourse, reproductive concerns due to trouble sperm deposition, and decreased pleasure with genital appearance [30].

The objectives of surgical repair in males with hypospadias comprise restoration of penile curvature to guarantee long, straight arousal, the extension of the urethra to enable proper flow of urine and sperm through the glans; and the development of an aesthetically normal penis. The surgeon must evaluate the defect's possible long-term importance and have an informed debate with the boy's parents about whether surgical intervention should be undertaken. In circumstances when the penis is straight when upright and the urethral opening is sufficiently distant to permit urination while standing, a repair may be of minimal value. To guarantee a satisfactory long-term outcome, continuing into maturity, repair should be performed with the fewest possible operations. This objective is attained by preparing the patient and family for the appropriate surgery, doing an accurate anatomic evaluation, and engaging in an open dialogue regarding the functional outcome and potential consequences.

Surgical timing is crucial. The timeframe of the repair should take into account the potential unfavorable psychological consequences of surgery, the anesthetic risk to the kid, the degree of penile growth that will assist a satisfactory repair, and the age-related changes in wound healing in boys [31]. The onset of genital awareness occurs at 18 months of life and increases with age [32]. Boys who had repair sooner (typically before 12 months of age) expressed less anxiety and had better psychosexual outcomes than boys who underwent repair later [33]. Boys who get corrective surgery at a younger age may also experience fewer problems, a result that underscores the need for early intervention [33]. In comparison, adult hypospadias surgery may be associated with a greater risk of complications [34]. In 1996, based on this research, the American Academy of Pediatrics Section on Urology advised that surgical intervention for hypospadias repairs be performed between both the ages of six and 12 months, with some exceptions in our current practice [35]. Given the seriousness and the necessity for numerous treatments, some standards place the best age for hypospadias correction within six and 18 months [30]. Those who did not recollect the operation were more likely to have a better body image and be content with their overall physical appearance. These findings relate to early-life surgery to reduce psychological load.

Aesthetic hazards, age-dependent tissue diameters, and emotional repercussions of genital surgery are all factors that have an impact [28]. When considering surgery for their young boy, many parents inquire about the appropriateness of anesthesia. In the last decade, disturbing discoveries about aesthetic-induced neurotoxicity in the growing central nervous system of rats have been reported. However, scientific concerns cast doubt on the applicability of these findings to people [36]. At two years of age, neurodevelopmental impairments were not detected in children subjected to anesthesia for hernia surgery, whether it was general anesthesia or regional anesthesia [37].

Therefore, the preoperative surgical evaluation with the boy's parents must include a thorough evaluation of the advantages of surgical repair against an age-appropriate explanation of the risks of general anesthesia.

Some anatomical characteristics, such as a short glans width and a thin urethral plate, are associated with greater postoperative problems and provide technical difficulty [38,39]. However, penile size is rarely considered a consideration in determining the ideal timing for hypospadias treatment, as penile development is minimal throughout the first few years of life. Therefore, delaying surgery appears to be without benefit [28].

In hypospadias surgery, the use of preoperative androgen stimulation is contentious. Some surgeons suggest testosterone supplementation for increasing anatomical proportions. Preoperative androgen stimulation in the form of dihydrotestosterone (DHT), human chorionic gonadotropin (hCG), or testosterone can be utilized to enhance the size of the glans and penis in preadolescent males [40,41]. It is believed that increasing glans size will reduce stress on the glansplasty and improve the amount of tissue accessible for urethroplasty, hence minimizing the risk of complications. Concerns associated with androgen stimulation in these boys involve abusive tendencies and behavior, enhanced erections, skin pigmentation, and secondary masculine characteristics. All traits are temporary and dissolve spontaneously, approximately six months following the final dosage [41]. Some surgeons omit preoperative testosterone as a consequence of the perceived greater risk of bleeding and enhanced angiogenesis. Others argue that the poor healing process may be attributable to subsequent androgen administration [42].

With more than 300 restorative surgical treatments documented in the present literature, it appears that a general strategy for hypospadias surgical correction is needed [43,44]. A reoperation rate of less than 5% is considered a good indicator of success. Hypospadias complications can occur in 5-10% of patients with mild variants and 15-56% of patients with severe forms, according to most estimates over the short term [3]. Short-term outcomes may not accurately represent the experiences of males throughout their adolescence. An accurate assessment of the long-term aesthetic and functional outcomes of the repaired penis cannot be made during a 12-month follow-up following surgery because psychosexual development and pubertal physical changes have not been completed [45,46].

Using magnification, atraumatic tissue manipulation, delicate equipment, suture materials, and proper hemostasis are the most fundamental prerequisites. In most cases, the anterior and middle hypospadias is corrected in a single procedure. On the other hand, a two-step treatment is frequently required for the posterior variant [3,28].

Intraoperative Assessment

Anesthesia does not signal the end of preoperative planning. Following antiseptic preparation and intravenous antibiotic treatment, the genitalia is scrutinized to decide the surgical strategy. Except for extremely severe cases of proximal hypospadias or subsequent surgical interventions, we do not perform cystoscopies on a normal basis. The preoperative evaluation of hypospadias should continue as described. The placement of the urethral meatus, the quality of the ventral shaft tissue, and the level of penile curvature are evaluated while the kid is sleeping. Depending on the extent of penile curvature, a circumferential incision is subsequently created, and the penis is partially or entirely degloved. Care must be taken to generate a mucosal collar by rotating inner glossy preputial tissue from the dorsolateral skin to the ventrum, where it is absent. This will help with ventral shaft skin covering and produce a more aesthetically pleasing outcome [47].

Penile Curvature: Diagnosis and Treatment

Whether or not hypospadias is present, a curved penile structure (chordee) may develop. The degree of curvature is a crucial factor in deciding between a one-stage and two-stage correction. The choice to treat men's scoliosis is based on their possible functional and aesthetic difficulties as they age into adulthood. Males suffering from untreated congenital curvature or Peyronie disease have been found to experience severe morbidity at even 20-30 degrees of ventral curvature, including difficulty with intercourse and patient displeasure with the look of the penis [48]. Curvature can be caused by reduced ventral skin, a small urethra, or the inherent curvature of the erectile body. Outside of surgery, it is exceedingly difficult to determine the source of curvature. The conclusive diagnosis is made with a simulated erection in the operating theatre after the penis has been degloved. Parents should be queried whether they see a history of penile curvature during erections and may even record this in their children with photographs. Before cutting the skin, the extent of curvature must be evaluated in the operating room. Through the insertion of a catheter into the meatus, the condition of the urethra and ventral skin may be determined. To remove dysplastic dartos tissue, a circumferential incision is created and the penis is degloved beyond the penoscrotal junction. Then, a mechanical erection should be conducted, often with a tourniquet inserted at the penoscrotal junction and a sterile normal saline injection [49]. Alternately, the surgeon can squeeze the corpora at the base of the penis to mimic an erection in tiny boys without the use of injections. In addition to saline injection, prostaglandin injection can be used to generate an erection [50]. Various approaches, such as unassisted visual examination and goniometry, which works as a protractor to reliably quantify the extent of penile curvature, are used to determine the degree of penile curvature. Other technological alternatives, such as tablets and applications, are beginning to appear.

Although there is no consensus about the treatment of particular degrees of curvature, the majority of surgeons appear to think that a dorsal plication is adequate for curvatures less than 30 degrees [51]. If the curvature is greater than 30 degrees, the urethra would need to be divided. A corporal curvature higher than 30 degrees at this point necessitates a corporal lengthening surgery that involves transection of the corpus spongiosum distal to the urethra or urethra transection [52]. As these males advance through puberty and experience more considerable penile development, their curvature may increase. Therefore, it is essential to diagnose and fix curvature during the first repair [53].

Distal Hypospadias Repair

Repair of distal hypospadias is one of the most frequent surgical operations performed by pediatric urologists, and several surgical approaches have been devised to treat this condition [47]. Different procedures are used to treat this condition.

There are a variety of repair operations that may be divided into advancement, tubularization, or the use of grafting and flap surgeries. Here, we are going to discuss the most commonly used surgical techniques in treating hypospadias.

The recommended surgical procedures for hypospadias correction may vary depending on the location of the meatus. Techniques such as the tabularized incised plate (TIP) urethroplasty, the Mathieu method, the meatal advancement and glanuloplasty incorporated (MAGPI), and the glans approximation procedure (GAP) are utilized to treat distal hypospadias.

It is possible to reconstruct the urethra in a single step or two. When feasible, the majority of surgeons now choose a single-stage operation. A single-stage technique is suitable for distal, mid-shaft, and proximal hypospadias without substantial chordee. When a single operation would not be adequate to correct a severe or perineal case of hypospadias with chordee, or when performing a difficult revision hypospadias surgery, a two-stage procedure may be necessary. The preponderance of surgeons now favors tubularization of the urethral plate as a one-step procedure [51].

The most prevalent single-stage technique is a Duplay-type operation with tubularization, with or without the vertical incision in the urethral plate, as described by Snodgrass [54].

The Thiersch-Duplay (TD) Repair

The Thiersch-Duplay (TD) repair, pioneered by Thiersch and later Duplay approximately 140 years ago, employs the brilliant notion of urethral tubularization of surrounding tissues distal to the misplaced meatus [55]. They completed their repair by producing a U-shaped incision from the penile shaft using vascularized skin and extending the meatus to the coronal edge. Later, for distant hypospadias, the restoration was covered with two layers of preputial skin [56]. This procedure comprises de-epithelialization of excess preputial skin and fastening across the repair to give a blood supply replacement. The next logical step was to stretch these U-incisions into the distal glans, tabularizing the glans itself over the repair, and providing a more aesthetically pleasing meatus at the penis tip [57]. The TD method requires a glans of sufficient width to accommodate a properly sized neourethral canal, at least one water-resistant layer, and glans flaps that may approximate over the repair. Parallel incisions are made 12 Fr in diameter lateral to the glans groove; the glans wings should be fully and extensively mobilized to enable tension-free covering. Under optical magnification, a dual running subcuticular suture is used to conduct neourethral reconstruction. If the child is circumcised, a de-epithelialized pedicle flap is harvested from the preputial tissue or the more proximal axis and placed over the complete neourethral restoration [58]. If the repair is more proximal, a double dartos flap can be obtained from the dorsal prepuce, with one flap running distally and the other flap running proximally. The circumcision defect is completed by approximating the glans wings into two layers (spongiosum and then epithelium), accompanied by the mucosal collar.

The Tabularized Incised Urethroplasty (TIP)

The TIP method, a variation of the TD, is a global standard surgical treatment for hypospadias. It was originally described in 1994 by Warren Snodgrass [59]. The surgical techniques are described below. A straight 8F sound is sent into the hypospadias meatus to evaluate skin covering across the urethra. In distal hypospadias, a demarcating incision is performed 2 mm proximal to the meatus, although a U-shaped incision may be prolonged proximally to healthy skin if necessary. Degloving the penis to the penoscrotal union. In every situation, an artificial erection is performed, as even coronal hypospadias is occasionally coupled with penile bending. If a minor chordee remains following skin release, dorsal plication is performed to rectify the corpora cavernosa's asymmetry. The tunica albuginea is incised longitudinally on either end just lateral to the neurovascular bundle opposing the point of curvature, followed by the placement of 6-0 Prolene sutures with the knots concealed. There is no need for substantial mobilization of the neurovascular bundle while performing dorsal plication. Next, 1:100,000 epinephrine is injected into the ventral glans at the visible intersection of the glans wings and urethral plate. Then, parallel incisions are made to detach the plate from the glans, and the glans wings are deployed laterally. Depending on its native groove, the plate is just 4 to 8 mm broad at this point. A linear relaxing incision is created from the inside of the meatus to the distal edge of the plate. This incision penetrates the epithelial surface of the plate and spreads deeper into the connective tissues underneath, reaching the corpus cavernosum. With the surgeon and helper maintaining counter-traction with tiny forceps, the plate is observed to be considerably widened upon division until further incisions offer no more mobility. Rather than a knife, tenotomy shears are indicated for this procedure so that an appropriate depth may be achieved without harming the corpus cavernosum. When the urethral plate is naturally grooved, the incision will be shallower than when the plate is naturally flat. Some surgeons perform the relaxing incision first, followed by parallel incisions to establish the plate's breadth. Despite this, this procedure regularly expands the plate to 13 to 16 mm, independent of its arrangement, assuring that the neourethra will be larger than 12F. If bleeding develops, epinephrine diluted 1:1000 is poured over the incision, and pressure is maintained for many minutes. If a tourniquet is required, it might be placed near the base of the penis. Electrocautery shouldn't be used to make holes in the plate or stop bleeding so that the plate's tissues and the corpora cavernosa underneath don't get hurt.

Next, a 6F stent is inserted into the bladder for urine diversion following surgery. The urethral plate is subsequently tabularized. To guarantee that the neo-meatus has a wide oval aperture, the initial stitch is always put at the level of the mid-glans, and no more than one or two stitches are removed distally. In this procedure, a single layer of 7-0 chromic catgut suture of full thickness is used. Those who prefer suture materials with a slower absorption rate might try subcuticular closures.

A thin dartos pedicle derived from the dorsal prepuce and shaft skin covers the whole neourethra. Glansplasty is then performed, commencing at the cornea and extending distally for a total of three stitches. Even though tiny sutures at the four and eight o'clock locations may evert the meatus somewhat for cosmetic purposes, securing the neourethra to the glans is not essential. The mucosal collar is approached in the midline, and the skin of the shaft is remodeled to resemble the median raphe. Subcuticular sutures are employed to avoid the suture tracts previously observed when 6-0 chromic catgut was put through the skin. After applying a dressing, the child is sent home [54].

Flap Methods

The Mathiew procedure is based on a meatal flap. This operation was documented for the first time in 1932, but it appears to have been performed earlier. The Mathieu method does not begin with penis degloving; rather, a penile shaft tissue flap is used to generate the neo-urethra. The Mathieu technique begins by determining the extent of the urethral gap from the meatus to the tip of the glans. Along the urethral plate, an equivalent distance is traced on the proximal penile shaft skin. An incision is created along these lines. For the proximal flap, an acceptable width of 7 to 8 mm is measured, with this width tapering to 5 to 6 mm towards the distal limit of the glans. After skin and glanular incisions, the shaft skin is degloved. The underlying tissue of the flap is dissected with care, enabling the flap to be advanced to the top of the glans. The flap is rolled over at the meatus and approximated to the lateral borders of the urethral plate with a running suture. Meatus has reached full maturity. The sutures are covered with a dartos flap of tissue, the glans wings are approached, and then a typical circumferential closure is done [60]. Concerns arise surrounding the vasculature of the utilized flap; if the flap's base is not adequately wide, the blood supply may be disrupted, hence increasing the prospect of fistula and stenosis. Others have expressed alarm at the fish-mouth look of the meatus. This method has been upgraded to the slit-like adjusted Mathieu (SLAM) process, which has shown favorable results, including an enhanced look of the meatus [61].

Advancement Techniques

Advancement methods do not necessitate tubularization of the urethral plate and are usually reserved for the most distal glanular meatus with minor penile curvature. Urethromeatoplasty employs the Heineke-Mikulicz concept, in which a longitudinal, vertical incision is made in the ectopic meatus and, subsequently, its margins are closed horizontally. This provides a cosmetically normal meatus and straightens the posterior urethral plate. This approach is especially beneficial in the presence of a stenotic, distal meatus with an accompanying blind-ending pit in the middle of a closed glans. The meatal advancement glanuloplasty would become one of the most often performed procedures to treat glanular hypospadias (MAGPI). The primary purpose of this operation is to distally advance the meatus without technically tabularizing the urethra [62]. The frequency of problems reported following the MAGPI technique complications occurs up to 10% [63]. Meatal stenosis and meatal regression are the most commonly encountered issues, while other uncommon complications consist of urethro-cutaneous fistulas and chordee.

The Glans Approximation Procedure (GAP)

The glans approximation method is a surgical approach developed for individuals with proximal glanular/coronal hypospadias who have a broad, steep glanular groove and a non-compliant or fish-mouth meatus, which is frequently found in the mega-meatus intact prepuce type [64].

Proximal Hypospadias Repair

The treatment of severe hypospadias has proven contentious. This disagreement persists as to the optimal treatment for proximal hypospadias. Numerous hypospadias correction procedures have been published, reflecting the difficulties of achieving optimal surgical outcomes for this illness [65]. Even though one-stage surgery has been shown to work for some types of proximal hypospadias, many people still prefer the more traditional two-stage method when moderate to severe chordee is present so that the length of the penis can be straightened during the first-stage repair.

One-stage proximal hypospadias correction often entails dorsal plication to restore ventral penile curvature and is one of many urethroplasty procedures. These can be differentiated according to the tissue employed in the repair, namely preputial skin, local skin, and buccal transplant. The preputial island flap is widely recognized as an innovation that Duckett contributed to [66]. In this procedure, the inner prepuce is elevated as a pedicle flap, translated ventrally, and used as an Onlay graft to cover the urethral plate following degloving the penis and straightening the chordee. Neo-urethras have a roof made up of the urethral plate. To prevent stricture development, the onlay excludes circular anastomosis. The inner prepuce is similarly employed as a pedicle flap in the Asopa variant of the technique, but the neo-urethra is left connected to the underside of the foreskin. Consequently, the skin and neo-urethra share a blood supply [67]. Higher complication rates were observed in the Duckett technique, and those included poor aesthetic results marked by excessive ventral bulkiness, penile torsion, and meatal anomalies; fistulas, strictures, total breakdown, and anterior urethral diverticuli formation [68].

The two-stage repair has been the preferred method of most surgeons for treating proximal hypospadias since the treatment of severe ventral penile curvature has shifted toward corporal lengthening techniques. Modern two-stage methods may be broadly classified, despite their many technical variants, into repair with free graft or repair with pedicle flap.

The Bracka two-stage repair is a urethroplasty technique that employs a free graft taken from the inner preputial skin or buccal mucosa [69]. STAG is an adaptation of Bracka's initial explanation [70]. In the first step, the penile curvature and urethral plate are rectified. A graft receiving bed is created by extending a midline incision into the glans. On the ventral penile shaft, compressive packing and patterning of the graft can reduce hematoma development and enhance graft uptake. Six months later, a U-shaped incision identical to the Thiersch-Duplay method is created, the urethra is tabularized, and glansplasty is carried out. Layered closure is performed to preserve vascular flow to promote healing [69]. The Byars flap treatment employs extra dorsal preputial skin, which is transferred ventrally with its vascular pedicle during the first surgery, as the urethral scaffold [71]. In the ventral part of the penis, the skin can be connected in the midline or positioned as a single unit, as in the STAG repair. In the second step, the neourethra is sealed by making a large U-shaped incision with a typical Thiersch-Duplay glansplasty. The development of a waterproof, two-layer closure and the establishment of a lumen of uniform diameter along the course of the urethroplasty are important technical elements. To guarantee that the neourethra retains a sufficient blood supply, several phases of closure are necessary. In particular, making a soft dartos bed above the clitoroplasty in the first step will ensure enough blood flow for the urethroplasty in the second step.

Regardless of the methodology, it is essential to evaluate the quality of the graft or flap during the second phase of the surgery. As an interim step, if skin deficit or tethering prevents safe closure, a dorsal inlay buccal mucosal transplant may be employed as an interim measure [72]. After graft harvesting, the urethra is rebuilt when all of the tissues are pliable. Alternately, the second step of repair can be performed simultaneously with a dorsal buccal graft inlay and a urethroplasty. It is essential to check that the penile curvature is rectified with a subsequent synthetic erection before urethroplasty. If needed, a dorsal plication or repeat corporal lengthening can be done to fix a slight curvature that keeps coming back.

The majority of early postoperative problems are caused by incorrect surgical techniques and may be readily avoided via improved procedure planning and tissue management.These problems include edema, hematoma development, wound dehiscence, flap decay, and fistula formation [73]. To prevent hematoma development, optimal hemostasis must be achieved. As previously stated, adequate tissue manipulation is required to prevent postoperative edema. A compression circumferential covering can also reduce postoperative edema.

There is a dearth of consistency in the literature when it comes to hypospadias correction procedures, as well as standardized definitions of problems and methods for evaluating outcomes [74]. Many questionnaires have been devised to evaluate the results of hypospadias treatment. Each questionnaire has its pros and limitations. These include the (Pediatric) Penile Perception Score (PPPS), the (Hypoplasia) Objective Scoring System, the (PedsQl), and the Hypoplasia Objective Penile Evaluation Score (HOPE) [75,76].

More than 70% of all patients who have hypospadias treatment are deemed cosmetically pleasing. More than 80% of males with repaired hypospadias had good sexual function [77]. However, these individuals are frequently prevented from initiating sexual interaction and frequently fear mockery due to the look of their genitals [77,78]. Symptoms of the lower urinary tract were twice as prevalent in individuals who had had hypospadias correction compared to controls [77]. After tabularized incised plate (TIP) urethroplasty, an obstructive urine flow pattern is usually observed, which may be due to aberrant elastic properties of the produced tube [79]. Almost 39% of patients who underwent proximal hypospadias surgery showed voiding problems, including hesitation and spraying [77]. Urinary problems (e.g., meatal stenosis, fistula, or urethral stenosis) may emerge years after the initial surgery; consequently, long-term follow-up is required [80].

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Hypospadias: A Comprehensive Review Including Its Embryology, Etiology and Surgical Techniques - Cureus

Woman, 20, jailed in UK for taking abortion pills when abusive partner got her pregnant – The Mirror

The young mum says she was threatened with life imprisonment and a child destruction charge if she didn't plead guilty - and has described the horrors of her life inside

Image: Getty Images/iStockphoto)

A university student was jailed for two years after taking pills that caused her to have an abortion.

The young mum, who had a two year old daughter when she became pregnant again aged 20, told of her horror that she ended up behind bars.

She was charged with taking pills that caused her to have an illegal abortion.

I felt I had no other choice other than to (plead guilty), Laura, not her real name, told the Sunday Times.

The prosecution said if I didnt plead guilty, they would charge me with child destruction, and I would likely go to prison for life.

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Last month the director of public prosecutions, Max Hill, was urged to urgently stop the prosecution of women who end their own pregnancies.

The number of women reported to the police for criminalised abortions has been on the rise with 30 so far in 2022 - already higher than previous years.

In an open letter signed by 66 organisations and people, including the British Pregnancy Advisory Service, barristers and womens rights groups, called for the prosecutions to stop saying women targeted are often "vulnerable" and in "desperate situations".

They pointed out that two women are facing prosecution in England now.

Referring to the US developments which saw abortion rights destroyed, the letter said: It is our strong belief that in the 21st century, in the shadow of the overturning of Roe v Wade, it is never in the public interest to prosecute women in these circumstances.

In reply Mr Hill said that abortion cases will be given an additional level of scrutiny from their lawyers before charges are brought against women.

While abortion is accessible, it is still officially a criminal act in the UK except in Northern Ireland, where it was decriminalised in 2019.

Under the Abortion Act and the Human Fertilisation and Embryology Act 1990, abortion is allowed up to 24 weeks of pregnancy if there is a risk to the physical or mental health of the women or her existing children.

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While there is no time limit for abortions if there is evidence of a fatal foetal abnormality or a significant risk to the mothers life.

But before an abortion can proceed, two doctors must ensure that the requirements of the Abortion Act are fulfilled, and they must both sign the certificate.

If a woman procures a miscarriage through medication without going through this process, it can be a criminal offence under the 1861 Offences Against The Person Act (OAPA). The maximum penalty is life.

New laws passed during the pandemic allow abortion pills to be taken at home up to ten weeks into a pregnancy but later abortions must be carried out in a medical setting.

But Laura is also calling for a change in the law, saying that women who have an illicit abortion only do so where someones in a very awful place in which theyve been given really no other choice.

The young mum eventually went on to graduate after serving a two-year prison sentence but says she still has nightmares about her ordeal.

Id never even had a detention at school. It was awful, she said.

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She said an abusive boyfriend told her not to go to the doctor but pills bought online instead.

At the time she believed she was eight to ten weeks pregnant when she climbed into the bathtub and gave birth.

I almost died, she says. I remember the bath being filled with at least an inch of blood.

I wanted to die. Honestly, I just felt like the whole world had just ended in front of my eyes.

She called an ambulance and was taken to hospital, where medics told her she had given birth to a 30-week foetus. According to the NHS, a full pregnancy is 40 weeks.

She admitted to the medics how shed taken abortion pills and police were called who guarded her bedside.

They actually had a police officer with me in the hospital the whole time and wouldnt let me speak to anyone other than the police, she said.

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She was only allowed a visit from her partner for 30 seconds when he whispered in my ear that he would kill me if I told anyone that he was involved.

They literally took me from the hospital, straight to the police station, she said.

Talking about her time behind bars, she said: I have seen things that no human being should ever see. The quality of life that those women have is disgusting. And I would not wish it on any single human being.

Ive seen people hang themselves. I have seen people slit their wrists and their legs, and people attack each other and over something so, so, so small.

Were in an environment with people who are vulnerable, and then mixed in with people who are violent. And that to me is not a safe place for someone like myself who is classed as vulnerable and very easily manipulated.

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Woman, 20, jailed in UK for taking abortion pills when abusive partner got her pregnant - The Mirror