A Quick Guide to Hypospadias

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If you notice that your son is not urinating in a manner considered usual, or has an unusually shaped penis, it is possible that he may have a condition known as hypospadias. In this article, we will give you everything you need to know about hypospadias, and whether or not your child will need medical attention.

What is Hypospadias?

Hypospadias (high-poe-spay-dee-us) is a congenital birth defect found in male children and infants, and is commonly found when the urethra (the tube-like part of the penis through which urine passes and is later expelled from the body) does not develop properly and is seen open in other areas of the penis besides the head. This condition is typically classified into one of three specific types depending on where the opening of the urethra is found:

  • Subcoronal, in which the urethra is found near the head of the penis;
  • Midshaft, in which the urethra is found along the shaft of the penis; and
  • Penoscrotal, in which the urethra is found between the penis and scrotum.

Although the condition on its own is generally rare, hypospadias is surprisingly common relative to other male congenital birth defects – according to the Center for Disease Control and Prevention, about 1 in 200 newborn males are born with this condition.

Is Hypospadias Dangerous?

Hypospadias on its own is not dangerous or life threatening to a child. However, this condition does have an impact on the development and formation of the child’s penis, which can manifest in certain anomalies and issues for the child later in life. For example, the foreskin of the penis may not form correctly, resulting in the head of the penis having a ‘hooded’ appearance; in rarer cases, the penis may actually curve downward, resulting in a condition known as a chordee.

Besides the changes to its appearance, a child with hypospadias may also develop other issues later in life due to these symptoms – for example, the child may have difficulty urinating because of the different location of his urethra and must therefore sit while peeing.

What Causes Hypospadias?

As of the time of publishing this article, doctors have yet to find a specific cause of hypospadias in infants. Doctors agree, however, that the emergence of hypospadias in children could be affected by genetics and external factors such as the lifestyle of the mother during pregnancy. Research data from the CDC has found a few of these external factors that could increase the risk of the baby having hypospadias at birth:

  • Maternal age & weight: Research has found that mothers over the age of 35 or who were obese during pregnancy were statistically more likely of having a baby with hypospadias.
  • Treatments & medicines: It has been speculated that the mother’s exposure to certain treatments or medicines could be linked to a higher risk of hypospadias in the baby; however, there is no conclusive evidence linking a specific substance to the increased risk as of yet.

How Is Hypospadias Diagnosed?

The occurrence and severity of hypospadias is found after a physical examination of the baby after childbirth. If the child is found with the condition, you will be referred to a paediatric surgeon for further examinations and to discuss treatment options.

Can Hypospadias Be Treated?

The treatment of hypospadias will vary slightly depending on the severity of the condition; however, most instances of hypospadias will require surgery to correct. At times, the penis of the child is not significantly affected by the hypospadias; in such cases, no medical intervention will be necessary.

The surgical procedure to treat hypospadias will correct the path of the urethra and re-route it to its natural position. The paediatric surgeon will also perform other procedures as necessary to restore the penis to a more natural appearance. In most cases the child will not need to undergo special preparations prior to the surgery; however, more severe instances of hypospadias will require a skin graft to be performed to properly reconstruct the scrotum or shaft and prevent future complications. As the paediatric surgeon will make use of skin from the foreskin of the patient to perform the skin graft, it is important for the patient to not have been circumcised prior to the surgery.

The surgery is typically performed when the baby is 6 to 12 months old if found early, but the procedure can be done at any age. The surgery also has a very high success rate, with complications occurring in about 10% of cases and arising within the first few months of surgery. Such complications include abnormal scarring around the treated area or the formation of a fistula, a hole that appears elsewhere on the penis. After the operation, your paediatric surgeon will give you instructions on caring for your baby’s penis to aid in its recovery. If your child has hypospadias and you have any concerns or questions about the condition, don’t hesitate to contact your paediatric surgeon for advice.