What Is Hypospadias? | Symptoms, Diagnosis, and Treatment

Hypospadias is a condition that occurs in male babies from birth. Normally, the opening of the urethra (where urine comes out) is located at the tip of the penis. In babies with hypospadias, this opening is located further back, on the underside of the penis. In some cases, the opening is only slightly away from the tip; in more severe cases, it can be as far back as the scrotum.

How Common Is It?

Hypospadias occurs in about 1 in every 200–300 male births. A family history of the condition, certain hormone medications, or environmental factors can increase the risk.

What Causes It?

While a baby is developing in the womb, the urethral tube is supposed to close completely. If it doesn’t close properly, hypospadias occurs. This can be related to hormonal imbalances or genetic factors.

Symptoms

The most obvious sign of hypospadias is that the urinary opening is not at the tip of the penis. Other possible signs include:

Urine stream pointing downward

Curvature of the penis (called chordee)

Excess foreskin on the top and missing foreskin underneath

Undescended testicles in severe cases

How Is It Diagnosed?

Diagnosis is usually straightforward: it’s noticed during a newborn’s routine physical exam. One very important point: If hypospadias is suspected, do not proceed with circumcision! The foreskin may be needed for surgical repair later.

In severe cases, hormone tests or genetic studies may be ordered.

Treatment

Treatment aims not only to correct urination but also to straighten the penis and ensure a normal appearance and function in the future.

Best time for surgery: Between 6 and 18 months of age.

Surgical methods: The choice depends on the location and severity. One of the most common techniques is the Snodgrass method (TIP urethroplasty).

After surgery, the child usually has a urinary catheter for a few days.

Possible complications: Urinary fistula (leakage), narrowing of the urethral opening, or recurrence of curvature. However, when performed at the right time by experienced surgeons, the success rate is high.

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