What is hypospadias?

Hypospadias is a relatively common congenital condition found in baby boys, in which the opening of the urethra is not found in its usual position at the end of the penis; instead it is located somewhere along the underside. The position of this opening (known as the urethral meatus) in hypospadias is most commonly at the junction of the head (glans) of the penis and the shaft, although it may be found anywhere along the underside of the shaft. In rare cases it may even be in or beneath the scrotum.


Symptoms of hypospadias

The main symptom of hypospadias is the fact that the urethral meatus is not at the tip of the penis. It is often accompanied by the following:

  • Chordee – a phenomenon where the penis curves downwards.
  • Hooded appearance of the penis, as only the top half has foreskin to cover it.

Hypospadias can also cause problems with penis function:

  • Abnormal spraying when urinating.
  • The boy may have to sit down to urinate when old enough to go to the toilet.
  • Problems with ejaculation and/or having children – it may be difficult to direct sperm into the uterus during intercourse.


What are the causes of hypospadias?

Hypospadias is a congenital condition, meaning it is present when the baby is born. During development in the womb, certain hormones control the development of the penis and the formation of the urethra and foreskin. It is thought that a malfunction in these hormones leads to hypospadias, but exactly what causes this malfunction is unclear. Theories include:

  • Genetics – hypospadias seems to run in families.
  • Age of the mother – the condition seems to be more common in babies born to mothers over the age of 35, making this a potential risk factor.
  • Weight of the mother – mothers classified as overweight have a higher risk of having a baby with hypospadias.
  • Exposure to certain substances in utero – it is thought that if the developing baby is exposed, via the pregnant mother, to certain chemicals, tobacco, alcohol, and even certain fertility drugs, that this could increase the risk of hypospadias, but more studies are required to confirm this.


Treatments for hypospadias

Minor hypospadias, where the opening of the urethra is not far from its proper position, often does not require treatment. In other cases, surgery will be required to reposition the urethral meatus, which may involve grafting tissue taken from the foreskin or from inside the mouth. In some cases, the shaft may also need to be surgically straightened. Surgery is usually performed after around 9 months of age.


Which type of specialist treats hypospadias?

Paediatric urologists are specialists in treating penile conditions in children, while paediatric surgeons may be required to perform a procedure to correct hypospadias.