Hypospadias (hi-po-SPAY-dee-us) is a very common birth abnormality among male infants. In general, of every 200 baby boys born, one baby will have the condition. If you have one son with hypospadias, the chance of having another baby boy with the same problem is about 10%. In other words, you would have a 90% chance that it would NOT happen again.
What is Hypospadias?
Hypospadias is an abnormality of the penis. To understand it, one must examine the normal penis anatomy. The urine tube (urethra) travels through the shaft of a normal penis. The urine tube (urethra) has an opening (meatus) at the head of the penis. This opening is usually in the center of the head of the penis (glans).
What is Different about the Penis when the Condition of Hypospadias is Present?
In boys with hypospadias the urine tube (urethra) is short and does not come out to the end of the penis. The opening (meatus) could be anywhere along the shaft of the penis or even in the scrotum. In addition, the foreskin is not evenly distributed around the end of the penis. Instead there is often scant foreskin on the underside of the penis and extra foreskin on the top. This makes the end of the penis look hooded. When hypospadias occurs, usually the penis shaft is also bent downward toward the scrotum. This curving is called CHORDEE (chord-ee). You can see it easily when the penis is erect.
Why is Hypospadias a Problem?
The position of the urinary opening (meatus) may make it difficult for your son to control the direction of urine flow. Urination may be straight down and in some cases the boy must sit down in order to urinate and hit the commode. Also, if the penis is curved (chordee), your son’s sexual activity may be altered when he is an adult.
What causes Hypospadias?
There is not single known cause of hypospadias. Some things that we know about possible causes of hypospadias are:
- The formation of the penis, which is completed by the 12th week of pregnancy, is affected by hormones given off by the mother’s placenta and the baby’s testes.
- During the development of the penis in the second month of pregnancy, if the movement of the opening of the urine tube (urethra) toward the head of the penis is blocked, hypospadias will occur.
What can be done to correct the Problem?
Circumcision is the removal of the foreskin to expose the head of the penis. We ask doctors not to circumcise boys with hypospadias. This tissue is used in the surgical repair. If a circumcision is desired, it is done at the time of the surgery to correct the hypospadias. We usually leave a small amount of extra skin in case further surgery is required for the hypospadias.
The surgery for hypospadias is often performed near the first birthday. The goals of the surgery are to:
- Straighten the penis
- Move the opening (meatus) of the urine tube (urethra) to a normal position at the top of the penis (glans)
- Have the penis look as normal as possible
If the hypospadias is quite severe, there may be a need to do the operation in stages, separated by a six to eight month waiting period. At times, more than one surgery may be required to correct the hypospadias. If the repair fails to heal correctly, leaking of urine along the area of repair may occur. Scar tissue may narrow the reconstructed tube. Great care is taken to provide the most normal penis that is possible. At times, irregularities require further surgery.
Remember that your son is an individual and will have his own special needs. Now that you have a general idea about hypospadias, your son’s physician will answer your further questions and will attend to his individual needs.