Hypospadias: Symptoms, Diagnosis and Treatment

What is Hypospadias? 

Hypospadias is a congenital condition in males where the opening of the urethra is located on the underside of the penis instead of at the tip. This abnormal positioning can affect urination and, later in life, sexual function. The severity of hypospadias varies; in some cases, the opening might be slightly misplaced, while in others, it could be located near the base of the penis or even in the scrotum. This condition is usually detected at birth and is relatively common, affecting about 1 in every 200 to 300 newborn boys. 

How Does the Penis Normally Work? 

Under normal conditions, the penis serves two main functions: urination and sexual reproduction. The urethra, a tube running through the penis, carries urine from the bladder to the outside of the body. During urination, the urethra transports urine, which exits through the meatus located at the tip of the penis. In sexual reproduction, the urethra also carries semen during ejaculation. Proper placement of the urethral opening is crucial for effective urination and reproductive functions. 


The exact cause of hypospadias is poorly understood, but it is believed to involve a combination of genetic and environmental factors. Hormonal imbalances during pregnancy may play a significant role, particularly those affecting the hormones responsible for male genital development. There may also be a hereditary component, as hypospadias can run in families. Additionally, exposure to certain environmental factors, such as endocrine disruptors in some plastics and pesticides, may increase the risk. 


Hypospadias is typically diagnosed during a newborn’s physical examination. A paediatrician or urologist will observe the position of the urethral opening and check for other abnormalities, such as a curved penis (chordee) or an incomplete foreskin. In some cases, additional tests like ultrasound or genetic testing may be required to determine if there are any associated conditions or to plan for surgical correction. 


The primary treatment for hypospadias is surgery, usually performed when the child is between 6 and 18 months old. The goal of the surgery is to reposition the urethral opening to the tip of the penis and to correct any curvature. The specific surgical technique depends on the severity of the condition. Some cases may require multiple surgeries to achieve the desired outcome. A pediatric urologist typically performs the surgery and has a high success rate, with most children achieving normal urination and sexual function. 

After Treatment 

Post-surgery, most children recover well and experience significant improvements. Parents must follow specific care instructions to ensure proper healing, including keeping the surgical site clean and monitoring for signs of infection. Pain management and regular follow-up appointments are crucial during the recovery period. In some cases, a catheter might be temporarily placed to aid urination while the surgical site heals. 


While surgery for hypospadias is generally successful, there can be complications. These may include fistulas (abnormal connections between the urethra and the skin), strictures (narrowing of the urethra), or persistent curvature of the penis. Some children might need additional surgeries to address these issues. Long-term complications are rare, but regular follow-up with a healthcare provider is essential to monitor for potential problems. 

Check-ups after Surgery 

Regular check-ups after surgery are vital to ensure that the penis is healing correctly and that there are no complications. The frequency and duration of these check-ups will depend on the individual case and the surgeon’s recommendations. Typically, initial follow-up visits are more frequent, gradually becoming less frequent if no issues exist. These visits provide an opportunity to address any concerns and to ensure that the child achieves normal urinary and sexual function as they grow. 

By understanding hypospadias, its diagnosis, and treatment options, parents can ensure their child receives the best care and support throughout their recovery journey. 

Related Blogs