Hypospadias is a congenital defect in which the
opening of the urethra is located on the under surface of penis, instead of at the end. In more severe forms of
hypospadias the opening of the urethra is in the middle or at the base of the
penis. Rarely, this opening is located in or behind the scrotum.
Due to this the hypospadias boys have to sit
down and pass urine. If they stand and pass urine like normal boys, the urine is deviated downwards towards their
As an adult, sexual activities become difficult
due to the abnormal curvature of the penis during erection. They have much
lower chance to have children, as they cannot deposit the sperm normally. The
sperm leaks out through the opening located underneath.
The exact cause of hypospadias is unknown. It
can be easily diagnosed at birth during routine physical examination.
Surgery usually restores the normal appearance of the
child's penis. When the problem is corrected by 1-3 years of age with a good
outcome, there should be no problem in future for fertility.Causes of Hypospadias
The cause of
hypospadias is often unknown. It is a congenital
Sometimes, hypospadias is
. It is more common in infants with a family
During the development of the penis in a male fetus,
certain hormones stimulate the formation of the urethra and foreskin. If
is a malfunction in the action of these hormones, the urethra develops
abnormally. The urethra is formed by the fusion of the urethral folds
ventral surface of the penis. Hypospadias occurs when there is
closure of the urethral folds.
Symptoms and Diagnosis of
Symptoms of hypospadias
depend on the severity of the condition. They include
Abnormal spraying of urine
Having to sit down to urinate to avoid the urine from running down to
Hooded appearance of the penis as only the top
half of the penis is covered with foreskin.
Chordee- Downward curve of the penis during an
Most infants with hypospadias are
diagnosed soon after birth during a physical examination.Treatment of Hypospadias
Hypospadias can be corrected with surgery.
surgery, the doctor uses tissue grafts from the foreskin or from the inside of
the mouth to reconstruct the urethra in the proper position, correcting the
hypospadias. If required the shaft of the penis is straightened and the excess
foreskin is circumcised.
Most of the hypospadias belong to the mild
variety and can be operated in a single stage operation. When the opening is
too far down from the tip, it might require two-stage operation.
The operation is usually performed between 4-12
months of age. The earlier the surgery is done it is less traumatic for the
child. However, the procedure can be completed at any age; even during
By completing the operation before 2-3 years of age,
these children can be toilet trained normally like any other child.