Learn About Hypospadias

What is the definition of 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 drains urine from the bladder. In males, the opening of the urethra is normally at the end of the penis.

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What are the causes of Hypospadias?

Hypospadias occurs in up to 4 in 1,000 newborn boys. The cause is often unknown.

Sometimes, the condition is passed down through families.

What are the symptoms of Hypospadias?

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 a downward curve of the penis during an erection. Erections are common in infant boys.

Other symptoms include:

  • Abnormal spraying of urine
  • Having to sit down to urinate
  • Foreskin that makes the penis looks like it has a "hood"
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What are the current treatments for Hypospadias?

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. Today, most urologists recommend repair before the child is 18 months old. Surgery can be done as young as 4 months old. During the surgery, the penis is straightened and the opening is corrected using tissue grafts from the foreskin. The repair may require several surgeries.

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What is the outlook (prognosis) for Hypospadias?

Results after surgery are most often good. In some cases, more surgery is needed to correct fistulas, narrowing of the urethra, or a return of the abnormal penis curve.

Most males can have normal adult sexual activity.

When should I contact a medical professional for Hypospadias?

Call your health care 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
What are the latest Hypospadias Clinical Trials?
Evaluation of Minipuberty in Infants Born With a Variation in Sexual Development

Summary: Disorders of sex development (DSD) occur in 1/3000 births and are defined by variation in aspect of external genital organs, e.g. cryptorchidism, hypospadias and micropenis in male infants and clitoral hypertrophy in female infants. Genetic, hormonal and environmental factors are implicated in DSD. Infants with congenital hypogonadism hypogonadotrope (CHH) can present with DSD. Evaluation of hormo...

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Effect of Caudal and Penile Block on Hypospadias Repair Complications

Summary: Hypospadias is one of the most common genitourinary (GU) malformations, seen in approximately 1 of 250 male live births. Common methods of local anesthesia administration for hypospadias surgery include caudal and dorsal penile nerve blocks. While both methods are known to be effective with minimal risk, the effect on post-operative complications is not well-established. The purpose of this random...

What are the Latest Advances for Hypospadias?
A simple technique to repair distal and mid-shaft hypospadias using a de-epithelialized Byars' flap.
Distal Urethral Advance and Glanduloplasty (DUAGPI) for Distal Hypospadias: A 15 Years Experience.
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Buccal versus skin graft for two-stage repair of complex hypospadias: an Egyptian center experience.
Who are the sources who wrote this article ?

Published Date: January 10, 2021
Published By: Kelly L. Stratton, MD, FACS, Associate Professor, Department of Urology, University of Oklahoma Health Sciences Center, Oklahoma City, OK. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

What are the references for this article ?

Elder JS. Anomalies of the penis and urethra. In: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020:chap 559.

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.

Rajpert-De Meyts E, Main KM, Toppari J, Skakkebaek NE. Testicular dysgenesis syndrome, cryptorchidism, hypospadias, and testicular tumors. In: Jameson JL, De Groot LJ, de Kretser DM, et al, eds. Endocrinology: Adult and Pediatric. 7th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 137.