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Hypospadias

Hypospadias (hi-poe-SPAY-dee-us) is a condition in which the opening of the urethra is on the underside of the penis, instead of at the tip. The urethra is the tube through which urine drains from your bladder and exits your body.

You may feel distressed if your son is born with hypospadias. However, hypospadias is common and doesn't cause difficulty in caring for your infant. In fact, surgery usually restores the normal appearance of your child's penis. With successful treatment of hypospadias, most males can eventually have normal adult sexual function.

Symptoms Causes Risk factors Complications

In hypospadias, the opening of the urethra is located on the underside of the penis instead of at the tip. The severity of the condition varies. In most cases, the opening of the urethra is near the head of the penis. Less often, the opening is at midshaft or at the base of the penis. Rarely, the opening is in or beneath the scrotum.

Signs and symptoms of hypospadias may include:

  • Opening of the urethra at a location other than the tip of the penis
  • Downward curve of the penis (chordee)
  • Hooded appearance of the penis because only the top half of the penis is covered by foreskin
  • Abnormal spraying during urination

When to see a doctor

Most infants with hypospadias are diagnosed soon after birth while still in the hospital.

However, it's possible that less severe hypospadias may be overlooked. Call your doctor if you notice your son's urethral opening is not at the tip of the penis, his foreskin is not fully developed or his penis curves downward.

Hypospadias is present at birth (congenital). The exact reason this defect occurs is unknown. Sometimes hypospadias is inherited.

As the penis develops in a male fetus, certain hormones stimulate the formation of the urethra and foreskin. Hypospadias results when a malfunction occurs in the action of these hormones, causing the urethra to develop abnormally.

Though the cause of hypospadias is unknown, both environmental and genetic factors have been associated with the condition, including:

  • Family history. This condition is more common in infants with a family history of hypospadias.
  • Maternal age over 40. Some research suggests that there may be an increased risk of hypospadias in infant males born to women of an advanced age.
  • Exposure to smoking and chemicals. There is some speculation about an association between a mother's exposure to pesticides and hypospadias, but further studies are needed to confirm this.

If hypospadias is not treated, a child may have problems learning to use a toilet properly. During adulthood, untreated hypospadias can cause difficulty in achieving an erection.

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