Hypospadias

Overview

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Hypospadias

Hypospadias

Hypospadias is a condition in which the opening of the urethra is on the underside of the penis instead of at the tip. The location of the opening can vary and can be anywhere from underneath the tip of the penis (more common) to the base of the penis (less common).

Hypospadias (hi-poe-SPAY-dee-us) is a condition that happens as the unborn baby, called a fetus, develops in the womb. The opening of the urethra is on the underside of the penis instead of at the tip. The urethra is the tube that drains urine from the bladder and out of the body.

Hypospadias is common and doesn't cause difficulty in caring for your baby. Surgery usually can create a typical looking penis that works properly. With successful treatment of hypospadias, most men can pass urine properly. And with successful hypospadias treatment, the condition won't block sperm from fertilizing an egg.

Symptoms

In hypospadias, the opening of the urethra is on the underside of the penis instead of at the tip. In most cases, the opening of the urethra is within the head of the penis. Less often, the opening is at the middle or the base of the penis. Rarely, the opening is in or beneath the scrotum.

Symptoms of hypospadias may include:

• Opening of the urethra at a place other than the tip of the penis.
• Downward curve of the penis. This condition is called chordee.
• Hooded appearance of the penis because only the top half of the penis is covered by foreskin.
• Differences in spraying when passing urine.

When to see a doctor

Most babies with hypospadias are diagnosed soon after birth while still in the hospital. But it may be harder to identify hypospadias if there's only a slight change in where the urethral opening is. Talk with your doctor or other healthcare professional if you have concerns about the look of your child's penis or if your child has problems passing urine.

Causes

Hypospadias is a condition that is present at birth. As the penis develops in a male unborn baby, certain hormones stimulate how the urethra and foreskin form. Hypospadias results from a change in the action of these hormones. This keeps the two sides of the urethral folds from joining completely. The location of the urethral opening depends on when the joining stopped.

In most cases, the exact cause of hypospadias is not known. Sometimes, hypospadias is caused by gene changes, but environment also may play a role.

Risk factors

Although the cause of hypospadias is usually not known, these factors may be linked with the condition:

• Family history. This condition is more common in babies with a family history of hypospadias.
• Genetics. Some gene changes may play a role in changing the hormones that stimulate how the male genitals develop.
• Maternal age over 35. Some research suggests that there may be a higher risk of hypospadias in male babies born to women older than 35 years.
• Exposure to certain substances during pregnancy. A link between hypospadias and a mother's exposure to certain hormones or certain compounds such as pesticides or industrial chemicals is being looked at. But more research is needed to confirm this link.

Complications

If hypospadias is not treated, it can result in:

• Differences in how the penis looks.
• Problems learning to use a toilet.
• Unusual curve of the penis with an erection.
• Problems releasing sperm from the penis. This release is called an ejaculation.