Hypospadias

Hypospadias is a congenital anomaly in which the urethral opening is at the base of the penis, or along the inferior aspect of the shaft of the penis. Hypospadias is usually associated with an abnormal curvature of the penis, called 'chordee.'

Hypospadias occurs in about 1 in 100 to 1 in 200 boys.

What is hypospadias:

Hypospadias is a malformation that affects the urethral tube and the foreskin on a male's penis. The urethra is the tube that carries urine from the bladder to the outside of the body. Hypospadias is a disorder in which the male urethral opening is not located at the tip of the penis. The urethral opening can be located anywhere along the urethra. Most commonly with hypospadias, the opening is located along the underside of the penis, near the tip

Causes of hypospadias:

Hypospadias is a congenital (present at birth) anomaly (abnormality), which means that the malformation occurs during fetal development. As the fetus develops, the urethra does not grow to its complete length. Also during fetal development, the foreskin does not develop completely, which typically leaves extra foreskin on the top side of the penis and no foreskin on the underside of the penis.It occurs in about one in every 150 to 300 boys. Hypospadias also has a genetic component. Eight percent of fathers of males with hypospadias also had the condition. Some studies show an increased risk for siblings to be born with hypospadias after the birth of one child with the problem.

Symptoms of hypospadias:

The following are the most common symptoms of hypospadias. However, each baby may experience symptoms differently. Symptoms may include:

• abnormal appearance of foreskin and penis

• abnormal direction of urine stream

• the end of the penis may be curved downward

The symptoms of a hypospadias may resemble other conditions or medical problems. Always consult your baby's physician for a diagnosis.

Diagnosis:

A physician or healthcare professional usually diagnoses hypospadias at birth. The malformation can be detected by physical examination.

Treatment

Hypospadias can be repaired with surgery. Usually, the surgical repair is done when the baby is between 6 and 12 months, when penile growth is minimal. The surgical repair can usually be done on an outpatient basis.

If a hypospadias deformity is not repaired, the following complications may occur: The urine stream may be abnormal. The stream may point in the direction of the opening, or it may spread out and spray in multiple directions.

Complications

• Complications of hypospadias surgery include:

• Urethral fistula

• Urethral stricture

Category: Nephrology Notes