ESR1 and hypospadias: In the prepuce, the mean ERα expression was highest in the control group (1.6 ± 0.5), followed by distal hypospadias (1.2 ± 0.5), mid-penile hypospadias (1.1 ± 0.6), and lowest in proximal hypospadias (0.6 ± 0.2).