HypospadiasSymptoms, Doctors, Treatments, Advances & More
Learn About Hypospadias
Hypospadias is a birth (congenital) defect in which the opening of the urethra is on the underside of the penis. The urethra is the tube that carries urine and semen through the penis and outside the body. In males, the opening of the urethra is normally at the end of the penis.
Hypospadias occurs in about 1 in 200 newborn boys in the United States. The cause is often unknown.
Certain factors may be associated with the condition, such as:
- Family history
- Genetic factors that affect how the urethra develops
- Maternal age over 35
- Maternal overweight or obesity
- Premature birth
- Low birth weight
Other factors may also play a role:
- Exposure to certain hormones
- Exposure to substances in the environment
Symptoms depend on how severe the problem is.
Most often, boys with this condition have the opening of the urethra near the tip of the penis on the underside.
More severe forms of hypospadias occur when the opening is in the middle or base of the penis. Rarely, the opening is located in or behind the scrotum.
This condition may cause the penis to curve down during an erection. Erections are common in infant boys.
Other symptoms include:
- Problems peeing without it spraying to the side or down (this can make it difficult to urinate while standing)
- Foreskin that makes the penis looks like it has a "hood"
Some boys with hypospadias have one or both testicles that have not moved down into the scrotum (undescended testicle).
The goals of treatment are:
- To ensure that urine and semen can pass normally through the urethra
- To have the opening of the urethra at or near the tip of the penis
- To correct any curvature so the penis is straight during an erection
Infants with hypospadias should not be circumcised. The foreskin should be kept intact for use in later surgical repair.
In most cases, surgery is done before the child starts school. Most urologists recommend repair when the child is between 6 and 12 months and before 18 months old. During the surgery, the penis is straightened and the opening is corrected using tissue grafts from the foreskin. For more complex cases, the repair may require several surgeries.
In some cases, if the hypospadias is very mild and there is no curve in the penis, surgery may be optional. However, even very mild cases may need to be repaired to prevent possible future problems. It's important to discuss the benefits and risks of treatment with your health care provider when deciding what is best for your child.
Fetal Treatment Center
Dr. Laurence S. Baskin is a urologist and an expert in genital development and reconstructive surgery. His focus is on providing care for the spectrum of pediatric urological conditions, including undescended testicles; blocked kidneys and ureters; prenatal urinary tract obstruction, such posterior urethral valves; adolescent varicoceles (enlarged veins in the testicles); differences in sex development ; cancers of the genital and urinary organs; and disorders that require urinary tract reconstruction. He founded the UCSF Center for the Study and Treatment of Hypospadias to advance care for this birth defect of the penile urethra (the tube through which urine is voided). Baskin has written extensively on hypospadias and genital reconstruction, lectures extensively on these topics and has produced videos on numerous surgical techniques. His laboratory focuses on investigating the causes of pediatric urological diseases – both those present at birth and those that develop later – to advance the prospect for cures. The lab looks specifically at how cells communicate during normal and abnormal development and at the effects of abnormal environmental exposures during pregnancy. Baskin earned his medical degree at the David Geffen School of Medicine at UCLA. He completed a general surgery residency at UCSF, followed by a fellowship in pediatric urology at Children's Hospital of Philadelphia. Baskin is a fellow of the American College of Surgeons and American Academy of Pediatrics. He is past president of the Societies for Pediatric Urology, Society for Fetal Urology, Asia-Pacific Association of Pediatric Urologists, American Association of Pediatric Urologists and Society of Genitourinary Reconstructive Surgeons. He is a member of the American Association of Genitourinary Surgeons, Societies for Pediatric Urology and American Urological Association (AUA). He is a past member of the American Board of Urology, serving on its exam committee, and served as assistant editor of the Journal of Urology (an official journal of the AUA). He is past head of the National Institutes of Health's study section on urologic disease, primary author on more than 300 research articles, and editor of “Handbook of Pediatric Urology” and “Hinman's Atlas of Pediatric Urologic Surgery.” Baskin has participated in humanitarian trips to perform pediatric urological surgery in Honduras and Vietnam. He has received numerous honors, including awards from the AUA and the European Society for Paediatric Urology. Dr. Baskin is rated as an Elite provider by MediFind in the treatment of Hypospadias. His top areas of expertise are Hypospadias, Intersex, Congenital Adrenal Hyperplasia (CAH), and Mixed Gonadal Dysgenesis.
Advocate Children's Medical Group Pediatric Urology
Mark Faasse is a Pediatrics provider in Oak Lawn, Illinois. Dr. Faasse is rated as an Advanced provider by MediFind in the treatment of Hypospadias. His top areas of expertise are Meatal Stenosis, Hypospadias, Varicocele, and Urinary Tract Infection (UTI).
St. Christopher's Hospital For Children
. Dr. Roth is rated as an Advanced provider by MediFind in the treatment of Hypospadias. His top areas of expertise are Hypospadias, Undescended Testicle, Testicular Torsion, and Diphallia.
Results after surgery are most often good. In some cases, more surgery is needed to correct:
- Fistulas (abnormal connection between the urethra and skin)
- Narrowing of the urethra
- A return of the abnormal penis curve
Most males can have normal adult sexual activity.
Contact your provider if your son has:
- A curved penis during an erection
- Opening to the urethra that is not on the tip of the penis
- Incomplete (hooded) foreskin
Summary: Hypospadias is a common congenital condition in boys in which the opening of the urethra is located on the underside of the penis. Distal hypospadias is the most common form and is usually treated surgically using tubularized incised plate (TIP) urethroplasty. In boys with an unfavorable urethral plate, graft-augmented techniques (G-TIP) are often used; however, postoperative complications such as...
Summary: The goal of this observational study is to learn if preoperative anxiety levels can predict the quality of early postoperative recovery, pain intensity, and the occurrence of emergence delirium in pediatric patients aged 2 to 7 years undergoing elective urogenital surgery, specifically hypospadias repair, orchidopexy, and hydrocele surgery. The main questions it aims to answer are: Does a higher l...
Published Date: March 31, 2024
Published By: Sovrin M. Shah, MD, Associate Professor, Department of Urology, The Icahn School of Medicine at Mount Sinai, New York, NY. Review provided by VeriMed Healthcare Network. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
Chan Y-M, Hannema SE, Achermann JC, Hughes IA. Disorders of sex development. In: Melmed S, Auchus, RJ, Goldfine AB, Koenig RJ, Rosen CJ, eds. Williams Textbook of Endocrinology. 14th ed. Philadelphia, PA: Elsevier; 2020:chap 24.
Di Carlo HN, Crigger CB. Anomalies of the penis and urethra. In: Kliegman RM, St. Geme JW, Blum NJ, et al, eds. Nelson Textbook of Pediatrics. 22nd ed. Philadelphia, PA: Elsevier; 2025:chap 581.
Long CJ, Zaontz MR, Canning DA. Hypospadias. In: Partin AW, Domochowski RR, Kavoussi LR, Peters CA, eds. Campbell-Walsh-Wein Urology. 12th ed. Philadelphia, PA: Elsevier; 2021:chap 45.