What is it?
Hypospadias is an abnormality of the penis which has three features:
- The urethral opening is not in the correct place - it is usually further back from the tip of the penis usually on the underside.
- There is often bending or curvature of the penis ("chordee"), which is more noticeable during erection.
- The foreskin is usually (but not always) missing on the underside, giving a hooded or incomplete appearance. The foreskin can sometimes be intact.
The condition is usually identified at birth but sometimes it can be missed for several years.
How common is it?
Hypospadias is common. It occurs in approximately 1 in 300 boys. The incidence is increasing.
What causes hypospadias?
The cause is unknown. It is usually an isolated abnormality. It is not strictly an inherited trait, like eye or hair colour, but it tends to occur more frequently in families where there is a history of hypospadias. The risk of having another child with hypospadias is about 1 in 30 or 14% of male siblings (so you should not let it affect your family planning).
Are there any associated problems with hypospadias?
Most boys with hypospadias have no other problems. However if the hypospadias is severe, there may be a need for further investigations, such as an ultrasound or blood tests to rule out other problems. Your surgeon will tell you if further investigations are recommended.
Will my son need an operation?
Most boys with hypospadias will usually benefit from an operation. The operation aims to do three things:
- Move the urethral opening to the end of the penis so that the child can stand and pass urine.
- Straighten the penis, so that sexual intercourse can physically occur.
- Normalise the appearance of the penis. The child will usually look circumcised after the repair.
If the boy’s hypospadias is mild, he has a good stream of urine and a straight penis on erection, an operation may not be necessary.
If an operation is recommended, ideally this should occur before the boy is 2 years old, although this may not always be possible. Your child does not usually need to stay in hospital overnight after surgery.
Sometimes more than one operation is needed to complete the repair. The need for a second operation may not arise for many years.
Can my son be circumcised before the operation?
It is important that the child NOT be circumcised before having the corrective surgery, as his foreskin is likely to be needed for the surgical repair.
- Hypospadias can be repaired.
- If you are worried, talk to your child’s surgeon.
- It is important not to circumcise your child if hypospadias is noted at birth.