Hypospadias

Definition

This is a birth defect of the penis. The defect involves the urethra. The urethra is the tube that connects the bladder to the outside of the body so that urine can exit. With hypospadias, the opening of the urethra develops on the underside of the penis. Normally, the opening is at the tip. Sometimes, other defects of the penis are also present. For example, the penis may have an abnormal downward curve. This is called chordee .
The Male Reproductive System
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Causes

Hypospadias occurs when the penis does not develop normally while the child is in the womb. This may happen when hormones do not stimulate the penis to develop normally. Often, the cause is unknown.

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

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

Diagnosis

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

Treatment

With mild forms, no treatment is needed. In severe cases, surgery is the only way to correct the defect. The surgery is done by a doctor called a pediatric urologist. If the urethral tissues cannot be brought back together, tissue grafts are taken 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 3-18 months old.

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