Hypospadias is a male birth defect in which the opening of the tube that carries urine from the body (urethra) develops abnormally, usually on the underside of the penis. The opening can occur anywhere from just below the end of the penis to the scrotum.
Hypospadias is a rare disorder, affecting only about 1 out of 250 live male births.1 A form of hypospadias in which the genitals are abnormally positioned can also develop in females.
In most cases, the cause of this birth defect is not fully understood. Treatment with hormones such as progesterone during pregnancy may increase the risk of hypospadias. Certain hormonal fluctuations, such as failure of the fetal testes to produce enough testosterone or the failure of the body to respond to testosterone, increase the risk of hypospadias and other genetic problems.
Mild hypospadias usually does not cause symptoms, especially in newborns and young children. If not surgically corrected, older children and adults may complain of difficulty directing their urinary stream and spraying urine. More severe cases of hypospadias make it impossible to urinate while standing.
Boys with hypospadias are also more likely to have an undescended testicle.
Hypospadias is usually diagnosed during the physical examination of a newborn. A test that may be useful if hypospadias is suspected is an excretory urogram. This test uses X-rays to provide pictures of the urinary tract. It is used to check for other congenital abnormalities of the kidneys or the tubes that carry urine from the kidneys to the bladder (ureters).
Hypospadias is sometimes treated with surgery to correct the placement of the urethral opening, usually during the first year of life. There are several different types of surgery, which may include repositioning of the urethra, correcting the placement of the urethral opening in the head of the penis, and reconstructing the skin of the area around the urethral opening. Because the foreskin may be needed for surgical repair, a baby with hypospadias should not be circumcised.
Complications, which are more likely to occur in older children and adults, can include bleeding, infection, narrowing of the urethra (stricture), and curvature of the penis.
Most males are able to urinate successfully from a standing position after surgical treatment of this condition.
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- Borer JG, Retik AB (2007). Hypospadias. In AJ Wein, ed., Campbell-Walsh Urology, 9th ed., vol. 4, pp. 3703–3744. Philadelphia: Saunders Elsevier.
Other Works Consulted
- McAninch JW (2008). Disorders of the penis and male urethra. In EA Tanagho, JW McAninch, eds., Smith's General Urology, 17th ed., pp. 625–636. New York: McGraw-Hill Medical.
|Primary Medical Reviewer||E. Gregory Thompson, MD - Internal Medicine|
|Specialist Medical Reviewer||Christopher G. Wood, MD, FACS - Urology, Oncology|
|Last Revised||September 3, 2010|
Last Revised: September 3, 2010
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