Hypospadias

What Is Hypospadias?

Hypospadias (hye-peh-SPAY-dee-iss) is when the urethra — the tube that drains pee (urine) from the bladder to outside the body — opens in a different place instead of at the tip of the penis. The opening may be on the underside or at the base of the penis.

What Are the Signs & Symptoms of Hypospadias?

A boy with hypospadias has one or more of these signs:

• The opening of the urethra is not at the tip of the penis.
• The foreskin only covers part of the tip (glans) of the penis.
• The penis is curved (called chordee, this might be noticeable only when the penis is erect).

What Problems Can Happen?

Whether hypospadias will cause problems depends on where the urethra opens. For example, an opening:

• near the tip of the penis usually causes no problems
• lower down on the penis may cause pee to spray
• far from the tip of the penis may cause problems with fertility

Chordee (KOR-dee) may or may not cause problems, depending on the bend: 

• A slight bend may cause no problems.
• A moderate to severe bend may cause problems later in life during sexual activity.

What Causes Hypospadias?

Doctors don't know exactly what causes hypospadias. Sometimes it runs in families. Kids with certain genetic conditions are more likely to have hypospadias. Babies born prematurely also are more likely to have hypospadias.

How Is Hypospadias Diagnosed?

Usually the baby's doctor notices hypospadias during the first check-up after delivery. Sometimes it is noticed during a well-baby check. Other times, a parent notices it when their baby's pee sprays from a different place than usual.

How Is Hypospadias Treated?

Most of the time, doctors do surgery to fix hypospadias. Some mild cases might not need surgery.

Depending on where the urethra opens and whether the child has chordee, a pediatric urologist (a surgeon who specializes in urinary issues in kids) will:

• move the opening closer to the tip of the penis
• straighten the curve of the penis, if needed

Parents may need to wait to circumcise (remove the foreskin of the penis) their child until after the hypospadias is fixed. Surgeons often use the foreskin to repair the hypospadias.

How Can Parents Help?

Talk to a pediatric urologist as you decide whether to circumcise your child. It may be important to leave the foreskin in place to use later to repair the hypospadias.