Hypospadias is a common condition occurring in 1 out of every 200 live male births. It is a condition in which the opening of the urethra (channel we pee through) is located on the underside of the penis rather than the tip of the penis. This opening can be located anywhere along the underside of the penis or in the scrotum.
Boys with hypospadias are frequently found to have a downward curvature of the penis (penile chordee) and incomplete foreskin on the underside of the penis. The lower position of the urethral opening on the penis can cause problems with the urinary stream and an ability to aim the stream into the toilet, because the stream is usually deflected downward. For these reasons, it is generally recommended that hypospadias be repaired surgically unless it is extremely mild. Risk factors for hypospadias are still not completely understood, but researchers believe hypospadias has a genetic link.
Symptoms of Hypospadias
Mild cases of hypospadias can go undetected at birth. If so, parents can help detect it by noticing a downward curve in the penis (chordee), spraying during urination or abnormal location of child’s meatus (pee hole).
There are three categories of hypospadias, including:
- Subcoronal or distal. The opening (meatus) is not at the tip of the head of penis or is just below it. Over 50 percent of boys affected have subcoronal hypospadias.
- Midshaft. The opening is halfway down the under side of the penis.
- Penoscrotal. The opening is in or beneath the scrotum, also called proximal or posterior hypospadias.
Some boys with hypospadias may also have inguinal hernias or undescended testicles. In some cases, children with hypospadias may have other genital or urinary tract abnormalities, but most of the time, hypospadias is an isolated condition.
At Riley at IU Health, our pediatric urologists may work with other specialists through our Disorders of Sexual Differentiation Program to find the best treatment plan for your child. Our team of specialists is ready to support you and your child through diagnosis and treatment.
Treatments
Treatments
Sometimes hypospadias is such a minor issue that treatment is unnecessary. In these cases, your baby boy can be circumcised as any other, if you wish. Even in mild cases, some families choose surgery for cosmetic reasons.
For more severe hypospadias, surgery is necessary to restore the normal appearance and preserve sexual function of a penis. Our pediatric urologists use established procedures with favorable long-term outcomes for children.
Children who have surgery for hypospadias usually need only one procedure to restore normal anatomy and appearance. Surgery repositions the urethral meatus (pee hole) and straightens the penis. The optimal age for your child’s surgery is usually around 9 to 12 months, depending on the severity and type of hypospadias. Severe penile anomalies may require surgery in stages to move the urethra, correct the curve of the penis and cover the penis with skin. Circumcision is typically done at the same time hypospadias is corrected.
If your child’s anatomy requires surgery, your physician may encourage you to delay your son’s circumcision because the foreskin can be used to make repairs. Complications are rare, but that often depends on the severity of the condition. Afterwards, your child can lead a normal, healthy life.
Pediatric urologists at Riley at IU Health are expertly trained to correct this difference. Our team treats 300 to 400 children each year for hypospadias.
Hypospadias surgery is usually an outpatient surgery and your child should be able to go home the same day. Sometimes your child has a small stent (plastic tube) in their penis to allow the repair to heal. Your child’s penis will be covered with a plastic dressing that stays for seven to 10 days, but he should return to normal within two days.
Key Points to Remember
Key Points to Remember
- Hypospadias occurs in one in every 200 to 250 baby boys in the United States.
- Some cases of hypospadias are more severe than others, and not every case needs treatment.
- Even the most severe cases of hypospadias are treatable with surgery.
- Boys who have minor hypospadias and those who have surgery to correct it lead normal, healthy lives.
Support Services & Resources
Support Services & Resources
We offer a broad range of supportive services to make life better for families who choose us for their children's care.
This organization has ties with the American Urological Association and advances research and education in urological care, working with healthcare providers, patients and caregivers. Their website provides articles and information on conditions such as hypospadias.
The CDC is part of the U.S. Department of Health and Human Services, which exists to protect Americans from health threats. The CDC publishes health information on conditions such as hypospadias.
This National Institutes of Health website offers information and links related to health conditions, including hypospadias.
Learn more about hypospadias surgery on the U.S. National Library of Medicine website.
Hypospadias Research
Hypospadias Research
Riley Hospital for Children currently has multiple ongoing research studies into hypospadias, including a study investigating the long term urinary, sexual, and psychosocial outcomes of adults who had a hypospadias repair in childhood.