Hypospadias
Hypospadias is a common condition that affects the male urethra (the tube that carries urine and semen out of the body). This overview will explain what it is, how it’s treated, and what to expect.
What is Hypospadias?
Hypospadias is a birth defect where the opening of the urethra (called the meatus), isn’t located at the tip of the penis as usual. Instead, it forms somewhere along the underside of the penis.
- How common is it? It’s one of the most common birth defects, affecting about 1 in every 200 male babies.
- What causes it? It happens early during pregnancy when the penis is forming. The exact cause is usually unknown, but it’s thought to be a combination of genetics and hormones. It is not caused by anything the parents did.
- Is it serious? In most cases, it’s a minor issue that is corrected with surgery.
Types of Hypospadias
Hypospadias is classified by where the urethral opening is located:
| Type | Location of Urethral Opening |
| Glandular (or Coronal) | Near the head (glans) of the penis. This is the mildest and most common type. |
| Penile (Midshaft) | Along the middle or shaft of the penis. |
| Penoscrotal/Perineal | Near the scrotum or even behind it. This is the most severe type. |
Related Conditions
Sometimes, hypospadias can occur with other issues:
- Chordee: A downward curve or bend of the penis, which may become more noticeable when the penis is erect.
- Hooded Prepuce: The foreskin doesn’t fully form underneath the penis, giving it a “hooded” appearance on the top.
Why is Treatment Needed?
Hypospadias is usually treated with surgery to ensure the child can:
- Urinate Standing Up: By moving the meatus to the tip, the child will be able to direct the urine stream properly.
- Have Normal Sexual Function: Correcting the curve (chordee) and making sure the urethra is in the right place is important for sexual function later in life.
- Improve Appearance: Surgery can help the penis look typical.
Treatment
Hypospadias Repair Surgery
The standard treatment for hypospadias is a single-stage or, sometimes, a two-stage surgery performed by a specialized pediatric urologist.
Surgery is usually done when the baby is between 6 and 18 months old. Operating on a child at this age is generally safe and allows them to heal before they are aware of the procedure.
The goals of the operation are:
- Straighten the Penis: The surgeon corrects the downward curve (chordee), if present.
- Create a New Urethra (Urethroplasty): The surgeon creates a new tube that extends the urethra to the tip of the penis. Tissues from the surrounding skin, or sometimes from the foreskin, are used to build this new tube.
- Position the Meatus: The new opening is carefully placed at the tip of the glans. Important Note: If your child has hypospadias, they should not be circumcised before the surgery, as the foreskin is often needed to help reconstruct the new urethra.
Post-Surgery Care and Recovery
- Catheter/Stent: A small, temporary plastic tube (stent or catheter) is often left in the newly constructed urethra for about 5 to 14 days. This allows the urine to drain and protects the repair while it heals.
- Dressing: The penis will be covered with a protective dressing for a few days.
- Pain Management: Your child will be given pain medication to keep them comfortable.
- Activity: It’s important to limit activity (like straddle toys or rough play) for a few weeks to allow for proper healing.
- Follow-Up: Regular check-ups with the urologist are crucial to monitor the healing and ensure the new urethra is working properly.
Children who have hypospadias repair surgery can expect to lead completely normal lives. They will be able to urinate, have normal sexual function, and have a typical appearance of the penis.
If you have concerns or questions, don’t hesitate to speak with your pediatric urologist. They are the best resource for information about your child’s specific condition and treatment plan.