Hypospadias

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Hypospadias

Topic Overview

What is hypospadias?

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.

What causes hypospadias?

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.

What are the symptoms?

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.

How is hypospadias diagnosed?

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).

How is it treated?

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.

Other Places To Get Help

Organizations

Canadian Urological Association
Web Address: www.cua.org
 

The Canadian Urological Association provides information about a variety of urological conditions in the patient information section on this Web site. Some of the pediatric topics are bedwetting, circumcision, and undescended testicle. Adult topics range from prostate, kidney, and bladder health to erectile dysfunction and vasectomy.


KidsHealth for Parents, Children, and Teens
4600 Touchton Road East, Building 200
Suite 500
Jacksonville, FL  32246
Phone: (904) 232-4100
Fax: (904) 232-4125
Web Address: www.kidshealth.org
 

This Web site is sponsored by Nemours Foundation. It has a wide range of information about children's health, from allergies and diseases to normal growth and development (birth to adolescence). This Web site offers separate areas for kids, teens, and parents, each providing age-appropriate information that the child or parent can understand. You can sign up to get weekly e-mails about your area of interest.


UrologyHealth.org, American Urological Association
1000 Corporate Boulevard
Linthicum, MD  21090
Phone: 1-866-RING AUA (1-866-746-4282) toll-free
Phone: (410) 689-3700
Fax: (410) 689-3800
Email: auafoundation@auafoundation.org
Email: patienteducation@auafoundation.org
Web Address: www.urologyhealth.org
 

UrologyHealth.org is a website written by urologists for patients. Visitors can find specific topics by using the "search" option.

The website provides information about adult and pediatric urologic topics, including kidney, bladder, and prostate conditions. You can find a urologist, sign up for a free quarterly newsletter, or click on the Urology Resource Center to find materials about urologic problems.


References

Citations

  1. Retik AB, Borer JG (2002). Hypospadias. In PC Walsh et al., eds., Campbell's Urology, 8th ed., vol. 3, pp. 2284–2333. Philadelphia: W.B. Saunders.

Other Works Consulted

  • McAninch JW (2004). Disorders of the penis and male urethra. In EA Tanagho, JW McAninch, eds., Smith's General Urology, 16th ed., pp. 612–626. New York: Lange Medical Books/McGraw-Hill.

Credits

By Healthwise Staff
Primary Medical Reviewer E. Gregory Thompson, MD - Internal Medicine
Primary Medical Reviewer Brian D. O'Brien, MD - Internal Medicine
Specialist Medical Reviewer Christopher G. Wood, MD, FACS - Urology, Oncology
Last Revised November 1, 2010

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