Hypospadias is a common birth defect in boys where the urethral opening is located on the underside of the penis rather than at the tip. It occurs when the urethra fails to form properly during fetal development. Treatment involves surgery to reposition the urethral opening, which is usually successful though there is a small risk of complications like fistulas or scar tissue formation. Left untreated, hypospadias can cause urinary issues and impaired sexual function later in life.
2. Hypospadias (hi-poe-SPAY-dee-us)
■ Hypospadias (hi-poe-SPAY-dee-us) is a birth defect (congenital condition) in
which the opening of the urethra is on the underside of the penis instead of at
the tip.
■ The urethra is the tube through which urine drains from your bladder and exits
your body.
■ Hypospadias is common and doesn't cause difficulty in caring for your infant.
Surgery usually restores the normal appearance of your child's penis.
■ With successful treatment of hypospadias, most males can have normal
urination and reproduction.
3.
4. DEFINITION
■ Hypospadias is a common structural difference of the penis where the urethra (the
tube that carries urine from the bladder to outside of the body) is on the underside
rather than the tip of the penis. The opening can be located anywhere on the under
surface of the penis to the scrotum.
■ A condition called chordee is often seen with hypospadias. Chordee is a downward
curve of the penis.This can occur with or without a hypospadias.
7. INCIDENCE:
• Hypospadias occurs in one out of every 150-300 boys.
• If a boy has hypospadias, there is a 15 percent chance that
his brother will have the condition.
• Eight percent of fathers who have a son with hypospadias
also have the condition
8. CLINICAL MANIFESTATION:
• Some boys with mild forms of hypospadias can have no symptoms
from their hypospadias.
• If the hypospadias and/or chordee is not repaired, your child may
have these issues as he grows:
• His urine stream may be hard to direct and control.
• The penis may curve as he grows, causing sexual dysfunction later in
life.
• If the urethral opening is near or behind the scrotum, he may have
fertility problems later in life.
9. COMPLICATION:
• Hypospadias surgery may be very successful, but there can be some potential
complications.
• In some cases, a hole or a fistula may occur, and urine may leak through the hole.
More surgery may be needed to repair this problem.
• Scarring within the urethra may occur and cause the urethra to narrow. This may
interfere with the passage of urine and would also need to be corrected with surgery.
• Patients may need to return for check-ups until after puberty.
• If hypospadias is not treated, it can result in:
o Abnormal appearance of the penis
o Problems learning to use a toilet
o Abnormal curvature of the penis with erection
o Problems with impaired ejaculation
10. TREATMENT:
■ Some patients with hypospadias do not undergo any treatment besides
observation, due to no symptoms or patient / family preference.
■ No medicine will correct a chordee or hypospadias, and the child is not
expected to outgrow these anatomical conditions.
■ Surgical treatment of hypospadias and chordee can change the
appearance of the penis and is desired by some patient / families after
discussion with their doctor
11. CIRCUMCISION
■ Circumcision is the surgical removal of the foreskin, the tissue covering
the head(glans) of the penis. It is an ancient practice that has its origin in
religious rites. Today, many parents have their sons circumcised for
religious or other reasons.
12. SUMMARY:
Men with a history of hypospadias surgery might be more
sensitive regarding the appearance of their penis, which would
have affected the outcome of the questionnaire-based studies.
Our data demonstrated that the severity of hypospadias and
endocrinological abnormality were significant factors affecting
penile size.
13. CONCLUSION
Hypospadias is a birth defect in boys in which the opening of the urethra is
not located at the tip of the penis. In boys with hypospadias, the urethra
forms abnormally during weeks 8–14 of pregnancy. The abnormal opening
can form anywhere from just below the end of the penis to the scrotum.
There are different degrees of hypospadias; some can be minor and some
more severe.
Editor's Notes
CAUSES:
The exact cause of hypospadias is unknown
Genetics.
It’s more likely if the boy has a father or brother who were born with it. It is also associated with some genetic syndromes.
Fertility treatments.
The mother may have used hormone therapy or medicine to help her get pregnant..
The mother’s age and weight.
There’s more chance a baby will be born with hypospadias if his mom is overweight and over age 35, has diabetes prior to her pregnancy
Exposure to smoking or pesticides
Premature
Risk factors
Although the cause of hypospadias is usually unknown, these factors may be associated with the condition:
Family history. This condition is more common in infants with a family history of hypospadias.
Genetics. Certain gene variations may play a role in disruption of the hormones that stimulate formation of the male genitals.
Maternal age over 35. Some research suggests that there may be an increased risk of hypospadias in infant males born to women older than 35 years.
Exposure to certain substances during pregnancy. There is some speculation about an association between hypospadias and a mother's exposure to certain hormones or certain compounds such as pesticides or industrial chemicals, but further studies are needed to confirm this
TYPES OF HYPOSPADIAS
The types of hypospadias include:
Distal or glandular:
The most common form when opening is found near the head of the penis.
Midshaft:
Occurs when opening is found in the middle to the lower shaft of the penis.
Penoscrotal:
This occurs when the opening is found where the penis and scrotum join.
Perineal:
Occurs when the opening is behind the scrotal sac. These are the most severe forms of hypospadias and the least common.