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Hypospadias

What is hypospadias?

Hypospadias is a common birth defect of the penis. The opening of the penis is not located at the normal anatomic location. The opening of the penis may be located anywhere from just below the tip of the penis to the scrotum, and occasionally below the scrotum. Boys with hypospadias often have extra foreskin on the top side of the penis and no foreskin on the underside of the penis. There may be an abnormality called chordee, curvature or bending of the penis, associated with hypospadias.

What causes Hypospadias?

Hypospadias occurs during the early part of gestation (pregnancy) from incomplete closure or fusion of tissue on the underside of the penis. It is not clear why hypospadias occurs. We know that it happens in about one of every 125 to 250 male births. It is sometimes inherited. Hypospadias is not due to something the mother did or did not do during pregnancy.

Why is it important?

Hypospadias may cause a deviation of the urinary stream so that the boy is forced to sit to urinate. Additionally, sexual function may be hampered by the location of the urethral opening or by the bend in the penis.

How is hypospadias diagnosed?

A diagnosis of hypospadius is often made on the child’s first physical exam. The location of the opening dictates the severity of the hypospadius.

  • Distal: mildest form of hypospadius; includes defects near the tip of the penis;occurs in 50 percent of cases.
  • Middle: moderate hypospadias; includes defects at the mid portion of the penis; occurs in 30 percent of cases.
  • Proximal: most severe hypospadias; includes defects near the scrotum; occurs in 20 percent of cases.

Can Hypospadias be corrected?

Yes. There is no medicine that will result in correction and the child will not outgrow the problem. However, surgery to correct the problem when performed by a surgeon experienced in genital reconstruction is usually successful. When possible, these operations are best accomplished between 6 to 18 months of age, when penile growth is minimal. In most cases, your child’s penis will look and function like a normal circumcised penis with minimal scarring.