With hypospadias, the opening of the urethra develops on the underside of the penis. The urethra is the tube that connects the bladder to the outside of the body so that urine can exit. In most boys, the opening is at the tip. The penis may also have a downward curve. This is called chordee .
The Male Reproductive System
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Hypospadias occurs when the penis develops while the child is in the womb. The cause of hypospadias is usually not known.

Risk Factors

Risk factors include:
  • Family history of hypospadias
  • Mother being older or having in vitro fertilization
  • Environmental exposures or fetal growth problems during the pregnancy


Symptoms may include:
  • Opening of urethra is not at the tip—may be near the underside of the penis head, along the shaft of the penis, or at the base of the penis
  • Downward curvature of the penis
  • Abnormal spray when urinating
  • Foreskin that only covers part of the head of the penis


This condition is usually diagnosed at birth. More tests may be done if your child has other conditions.


With mild forms, no treatment is needed. If the condition causes functional problems, surgery may be done. The surgery is done by a doctor called a pediatric urologist. If the urethral tissues cannot be brought back together, tissue grafts are used, usually from the foreskin or inside of the mouth. These grafts are used to:
  • Reconstruct the opening of the urethra
  • Straighten a curved penis
Surgery is typically done when the child is 6-18 months old, but may be done at any age.

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