Hypospadias is a malformation that affects the urethral tube and the foreskin on a male's penis. The urethra is the tube that carries urine from the bladder to the outside of the body. Hypospadias is a disorder in which the male urethral opening is not located at the tip of the penis. The urethral opening can be located anywhere along the urethra. Most commonly with hypospadias, the opening is located along the underside of the penis, near the tip.
Hypospadias is a congenital (present at birth) anomaly (abnormality), which means that the malformation occurs during fetal development. As the fetus develops, the urethra does not grow to its complete length. Also during fetal development, the foreskin does not develop completely, which typically leaves extra foreskin on the top side of the penis and no foreskin on the underside of the penis.
According to pediatric neurologists:
The following are the most common symptoms of hypospadias. However, each baby may experience symptoms differently. Symptoms may include:
The symptoms of a hypospadias may resemble other conditions or medical problems. Always consult your baby's physician for a diagnosis.
A physician or health care professional usually diagnoses hypospadias at birth. The malformation can be detected by physical examination.
Specific treatment for hypospadias will be determined by your baby's physician based on:
Your baby's gestational age, overall health, and medical history
The extent of the condition
Your baby's tolerance for specific medications, procedures, or therapies
Expectations for the course of the condition
Your opinion or preference
Hypospadias can be repaired with surgery. Usually, the surgical repair is done when your baby is between 6 and 24 months, when penile growth is minimal. At birth, your male child will not be able to undergo circumcision, as the extra foreskin may be needed for the surgical repair. The surgical repair can usually be done on an outpatient basis (and may require multiple surgeries depending on the severity).
If a hypospadias deformity is not repaired, the following complications may occur as your child grows and matures:
The urine stream may be abnormal. The stream may point in the direction of the opening, or it may spread out and spray in multiple directions.
The penis may curve as your baby grows causing sexual dysfunction later in life.
If the urethral opening is closer to the scrotum or perineum, your baby may have problems with fertility later in life.
Please consult your physician with any questions or concerns you may have regarding this condition.
At Children’s National in Washington, DC, our pediatric urologists provide comprehensive care for disorders affecting reproductive and urinary organs.
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Craig Peters, MD, is the chief of Surgical Technology and Translation and Principal Investigator in the bioengineering initiative at the Sheikh Zayed Institute for Pediatric Surgical Innovation.
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