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Pediatric Diseases and Conditions

Hypospadias

What is hypospadias?

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.

What causes hypospadias?

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.

Who is affected by hypospadias?

According to pediatric neurologists:

  • Hypospadias is a disorder that primarily affects male newborns.

  • Hypospadias also has a genetic component. Some fathers of males with hypospadias also have the condition. 

  • Prematurity and low birth weight 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 consult your baby's physician for a diagnosis.

How is hypospadias diagnosed?

A physician or health care professional usually diagnoses hypospadias at birth. The malformation can be detected by physical examination.

What is the treatment for hypospadias?

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.

Publication Source: Nelson Textbook of Pediatrics. Kleigman, Robert M. 18th edition, 2007, p. 544.
Publication Source: Pediatric Urologic Disorders In Urologic Diseases in America. Pohl, Hans G. 2007, pp. 401-405.
Online Source: American Academy of Pediatricshttp://www.healthychildren.org/English/health-issues/conditions/genitourinary-tract/Pages/Hypospadias-A-Birth-Defect-of-the-Penis.aspx
Online Source: Merck Manual for Health Care Professionalshttp://www.merckmanuals.com/professional/pediatrics/congenital_renal_and_genitourinary_anomalies/penile_and_urethral_anomalies.html
Online Source: American Urological Associationhttp://www.urologyhealth.org/urology/index.cfm?article=130
Online Source: National Institute of Diabetes and Digestive and Kidney Diseases National (NIDDK)http://www2.niddk.nih.gov/NR/rdonlyres/9D6B412C-7727-49E3-B15B-75DC5500158B/0/Pediatric_Urology_Feb_2006_Chapter_2.pdf
Online Editor: Green, Chelsea
Online Medical Reviewer: Bass, Pat F. III MD, MPH
Online Medical Reviewer: Finke, Amy, RN, BSN
Date Last Reviewed: 1/30/2013
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