Epidermal growth factor (EGF) and EGF receptor in hypospadias

Objective To determine whether alterations in epidermal growth factor (EGF), which plays a major role both in the masculinization of the genitourinary tract and in wound healing, or EGF receptor (EGFR) expression are associated with hypospadias. Patients and methods The prepuces from 22 children undergoing circumcision (median age 27 months, range 5-87) and skin biopsies from 16 children undergoing surgery for hypospadias (median age 12 months, range 3-57) were studied. Fourteen patients had distal, one had mid-shaft and one had penoscrotal hypospadias. Immunoperoxidase staining was carried out for EGF and EGFR and the density of the staining quantified using image cytometry by an operator unaware of the diagnosis. Results The median EGF density in foreskins obtained by circumcision was 75% (mean 73, SE 2.1) compared with 54% (mean 52, SE 3.9) for tissue samples from patients with hypospadias (P<0.001); the mean EGFR was similar in both materials, Conclusion The mean EGF value was deficient in skin adjacent to hypospadias defects compared to normal phallic skin, suggesting that the inadequate expression of EGF may be related to the aetiology of hypospadias and to possible wound complications following surgery for hypospadias.