Prenatal DES exposure also induces malformations of the external genitalia in the third generation
Diethylstilbestrol, known as DES – marketed in France under the brand names Distilbène® and Stilboestrol-Borne®, is one of the most well studied endocrine disruptor to date. It is a nonsteroidal synthetic estrogen, teratogenic, carcinogenic and genotoxic.
Heralded as a medical miracle for preventing miscarriage and premature labor, DES has been prescribed to pregnant women between 1940 and 1977 (in France).
Later, it was learned that infants whose mothers took DES while pregnant were more likely to have healthy such as anatomic anomalies, reproductive changes and increase risk of developing cancers.
DES also harms the descendants of men and women exposed developmentally to diethylstilbestrol. Its transgenerational effects have been widely demonstrated.
The research objective of this 20141 study is to investigate the transgenerational effects of diethylstilbestrol on development of external genitalia of mices.
Study uncovers link between prenatal exposure to diethylstilbestrol and the development of abnormalities of the external genitalia in the DES third generation (DES Grandchildren).
Thus, this study highlights in the third generation:
A high rate of hypospadias (20%)
A 20022 study had already shown an increased risk of hypospadias in the sons of women exposed to DES in utero
Hypospadias is a male birth defect (congenital condition) in which the urethra does not open from its usual location at the tip of the penis. The opening of the urethra can be located at various locations along the underside of the penis, at the base of the penis or at scrotal level.
The consequences are a "crooked" jet of urine, difficulties in having normal sexual intercourse, according to the position of the meatus and the curvature of the penis, and for severe hypospadias surgery might be needed; sometimes, multiple surgeries are required.
If your newborn son has been diagnosed with hypospadias, it is not recommended to have him circumcised, as foreskin is sometimes used during reconstructive surgery.
A high rate of urethral-vaginal fistula (11.9%)
An urethral-vaginal fistula (UVF) is an abnormal opening that connects your vagina to urethra (the tube that carries urine from the bladder out of the body).
The majority of UVFs occur after gynecologic surgery such as a hysterectomy or cesarean section, after pelvic radiotherapy or after a difficult childbirth. Congenital urethrovaginal fistula is an extremely rare.
This causes leakage of urine from the vagina. Depending on the location of the fistula, complications (urinary incontinence, stenosis of the urethra, etc.) can occur postoperatively. Multiple surgeries may therefore be required.
Diagnosis of UVF can be confirmed by a Computerized tomography (CT) urogram of the pelvis and MR imaging.
These two abnormalities were already present in the second generation (DES daughters and DES sons) and, here, are transmitted from one generation to the next.
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1 Mahawong P, Sinclair A, Li Y, Schlomer B, Rodriguez E Jr, Ferretti MM, Liu B, Baskin LS, Cunha GR. Prenatal diethylstilbestrol induces malformation of the external genitalia of male and female mice and persistent second-generation developmental abnormalities of the external genitalia in two mouse strains. Differentiation. 2014 Sep-Oct;88(2-3):51-69. doi: 10.1016/j.diff.2014.09.005. Epub 2014 Oct 14.
2 Klip H, Verloop J, van Gool JD, Koster ME, Burger CW, van Leeuwen FE; OMEGA Project Group. Hypospadias in sons of women exposed to diethylstilbestrol in utero: a cohort study. Lancet. 2002;359(9312):1102-1107. [PubMed] [Google Scholar]
3 Imagerie de l’urètre féminin - Scientific Figure on ResearchGate. Available from: https://www.researchgate.net/figure/Fistule-uretrovaginale-Cystographie-mictionnelle-de-face-a-et-de-profil-b-Noter_fig18_226590753 [accessed 17 Jan, 2020]