Definition: When the opening normally at the end of
the penis is located on the undersurface of the penis.
1. What caused this condition to occur?
There are multiple possible causes with genetic, environmental, and
hormonal factors influencing development of the penis. No one is
certain as to the exact cause of this condition. The incidence of
hypospadias has been increasing worldwide over the past few decades.
The incidence is approaching 1 percent of newborns.
2. What tests need to be done to further define the
condition?
Typically, the diagnosis is made on physical examination of the newborn.
The majority of boys with hypospadias will need no further evaluation to
help plan a treatment course. If your child has an undescended testicle
along with hypospadias, blood testing to evaluate for an endocrine
problem or other developmental conditions should be performed. Some cases of severe hypospadias may also require such testing. It is not recommended to perform newborn circumcision in patients with hypospadias as
the foreskin may be useful in reconstruction at a later date.
3. What kind of symptoms or problems can occur as a
result of the condition?
The penis has basically two functions: urination and sex. Children
with uncorrected hypospadias may be impacted in either or both of
these categories. Penile curvature (chordee) associated with hypospadias may make penetration painful or difficult to achieve. Depending
on the location of the urethral opening, urinating while standing may
be impossible to perform without significant spraying and deflection
of the urine stream. If the hypospadia is corrected, there should be no
future problems in either area.
4. Will it need to be corrected? If so, when and how?
Almost all cases of hypospadias require surgical treatment, although
some of the most minor hypospadias may not require any intervention. Many pediatric urologists will recommend surgery to be
performed after four months of age. There are over two hundred described techniques that are used for
hypospadia repairs. Your physician will discuss the technique that will
be best suited for your son’s particular anatomy. There has been much
advancement in technique over the past years, and now hypospadia
repair is almost always done as a day surgery on an outpatient basis.
5. Do we need to see a urologist and, if so, when?
The timing of urologic consultation is up to you and your pediatrician.
Hospital consultation may be warranted if there are concerns or uncertainty about the diagnosis. Otherwise, outpatient consultation is
completely appropriate and can be performed anytime between zero
and two months of age.
6. Is there a possibility that there will be a problem
later on in sexual or urinary function?
As discussed above in question #3, there can be impact on both sexual
or urinary function in patients with hypospadias. If the problem is
corrected early in life, it is unlikely that there will be any future issues
in either of these areas.
7. When do you wish to see my child again for this
condition?
After the initial consultation with your urologist, either scheduling
for correction or a follow-up visit for your child at around two months
of age may be recommended. This will be influenced by the degree of
hypospadias and any other medical issues that your child may have.
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