Hypospadias

Hypospadias is a complex of abnormalities that affect a male’s penis, where the main problem is that the urethral tube is underdeveloped, the forskin doesn’t completely cover the head of the penis, and there is curvature of the penis. The tube that carries urine from the bladder to the outside of the body is called the urethra. Hypo (below) spadias (opening), is a disorder in which the male urethral opening is along the underside of the penis. More commonly with hypospadias, the opening is located near the tip; less common the opening is near the scrotum. Hypospadias can be graded mild, moderate, or severe; (or sometimes referred to as glanular, midshaft, or penoscrotal). About 85% of boys with hypospadias have a mild degree.

Hypospadias occurs during fetal development. As the fetus develops, the urethra does not grow to its complete length. Also the foreskin does not develop completely, which typically leaves extra foreskin on the topside of the penis (looks like a hood), and no foreskin on the underside of the penis. Many times the underside of the penis pulls the head downward, which causes curvature. Nobody knows why this happens, but there are number of theories under considersation. There are many variants , and can occur in about 1 /100 births. Sometimes it can run in families (20%).

Rarely, newborn boys with hypospadias may also have other congenital abnormalities such as undescended testes. These boys will have genetic testing.

Epispadias, which is markedly less common than hypospadias, is typically seen in children with exstrophy of the bladder (a condition where the abdominal wall is partially open leaving the bladder exposed). In epispadias, the urethral opening is located on the topside of the penis, and the penis curves upward. This happens in about 1 in a million live births.