Introduction

Hypospadias is a condition where the penis grows differently.

The shaft of the penis holds the urethra. The urethra is a tube that carries urine out of the bladder and semen out of the testicles. The end of the urethra will usually come out of the tip of the penis.

In hypospadias, the end of the urethra comes out of the underside of the penis.

Children with hypospadias will generally not have any other health issues. It is a common condition and happens in about 1 in every 300 penises.

The cause of hypospadias is unknown, but it can happen more often when there is a family history of the condition. If you have a child with hypospadias, there is a 14% chance you will have another child with the condition.

Usually, the urethra will come out of the tip of the penis. Children with hypospadias will have the opening of their urethra on the underside of the penis, anywhere from underneath the tip, down the shaft and back towards the anus.

If your child has hypospadias, they may also have:

• chordee – when the penis bends or curves, more noticeable when the penis is erect or hard
• a foreskin that is partially missing on the underside of the penis.

Sometimes, the hypospadias is mild and may not be noticeable until your child is older.

Hypospadias is usually diagnosed when your baby is born based on the appearance of the penis. Sometimes, it is missed until your child is older.

If the hypospadias is severe, your child may need other tests like an ultrasound or blood test to figure out whether there are any other conditions.

Mild hypospadias does not always need treatment if your child can urinate properly and the penis is reasonably straight when erect.

More severe hypospadias can be treated using surgery, called a hypospadias repair. This operation is best done before the age of 2 if possible.

Aim of treatment

The hypospadias repair procedure will:

• move the opening of the urethra to the tip of the penis so your child can urinate well while standing
• straighten the penis out to make sexual intercourse physically possible when your child becomes an adult
• make the appearance of the penis look more average.

Circumcision

If your child is born with hypospadias, do not have their penis circumcised before the repair surgery. The skin of the foreskin can be used to rebuild the penis.

Recovery

If your child recovers well after the procedure, they should be able to go home the same day.

The doctor will give you information about pain medicine and will make an appointment to check in after about a week.

Future procedures

Some children will need more than one procedure to repair the penis properly. This can happen years later.

Talk to your child’s doctor if you have any questions or concerns about hypospadias and the repair procedure.