What is hypospadias?

Hypospadias is a malformation that affects the opening of the urethra 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.

What causes hypospadias?

Hypospadias is a congenital (present at birth) anomaly (abnormality). This means that the malformation happens during fetal development. As the fetus develops, the tissue covering the underside of the penis that forms part of the urethra doesn't completely close. Also during fetal development, the foreskin does not develop completely. This typically leaves extra foreskin on the top side of the penis and no foreskin on the underside of the penis.

Who is affected by hypospadias?

According to pediatric urologists:

  • Hypospadias is a disorder that primarily affects male newborns.

  • Newborns of older mothers are at an increased risk. 

  • Newborns of fathers with conditions affecting the genitourinary system are more likely to have hypospadias. 

  • Prematurity, low birth weight, and twin gestation are also considered risk factors for hypospadias.

What are the symptoms of hypospadias?

The following are the most common symptoms of hypospadias. However, each baby may experience symptoms differently. Symptoms may include:

  • Abnormal appearance of foreskin and penis on exam

  • Abnormal direction of urine stream

  • The end of the penis may be curved downward

The symptoms of a hypospadias may resemble other conditions or medical problems. Always see your baby's healthcare provider for a diagnosis.

How is hypospadias diagnosed?

A healthcare professional usually diagnoses hypospadias at birth. The malformation can be detected by physical exam.

What is the treatment for hypospadias?

Your baby's healthcare provider will figure out the best treatment for your baby based on: 

  • How old your baby is 

  • His overall health and past health

  • How sick he is

  • How well your baby can handle specific medicines, procedures, or therapies

  • How long the condition is expected to last 

  • 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. This is 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 happen 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. This causes 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 talk with your baby's healthcare provider with any questions or concerns you may have regarding this