What Is Hypospadias?
Hypospadias is a common congenital anomaly (birth defect) of the penis. The urethral opening (meatus) is at or just below the junction where the glans joins the shaft of the penis. It can, however, be as far back as the scrotum. In addition, boys with hypospadias are often missing the undersurface half of their foreskin so that it forms a hood. There is often a bend (called chordee) in the erect penis.
What Causes It?
Hypospadias results from incomplete development of the urethra. It is sometimes inherited. Other than inherited cases, the cause is usually not known.
Why Is It Important?
Hypospadias may cause deviation of the urinary stream so that the boy is forced to sit to urinate. Additionally, sexual function may be hampered by the location of the urethral opening or by the bend in the penis.
Can a Circumcision Be Performed?
No. A circumcision should not be performed during the newborn period. The foreskin may be needed for the repair of the hypospadias.
Can It Be Corrected?
Yes. There is no medicine that will result in correction and the child will not “outgrow” the problem. However, surgery to correct the problem, when performed by a surgeon experienced in genital reconstruction, is usually successful. When possible, these operations are best accomplished between 6 and 18 months of age. Most of the time repair can be achieved in a single operation of one to four hours duration. The child may leave the hospital the same day as the surgery (ambulatory surgery). In some instances it will best to hospitalize the child for several days after the operation. The child often needs a catheter (a tube to drain urine during healing) for several days after the operation. He can still go home the same day as the surgery with the catheter. The catheter and bandage will be removed in the office several days later.
What Is the Long-Term Outlook for Boys with Repaired Hypospadias?
Following surgery most boys have normal function and a good cosmetic result. Long-term studies suggest that these boys do well emotionally as well. Fertility and potency would be expected to be normal after repair.