Hypospadiasis is a congenital condition where the urethral opening is located on the underside of the penis, which can occur in varying degrees of severity. The condition can result from genetic, hormonal, and environmental factors, and it has distinct clinical manifestations such as a downward urine stream and incomplete foreskin. Treatment typically involves surgical correction to reposition the urethral opening, with postoperative monitoring to ensure proper healing and function.

1. HYPOSPADIASIS
Presented By:
Mr. NANDISH.S
Associate Professor
Mandya Institute of Nursing Sciences

2. DEFINITION :
 It is a congenital condition in which the opening of urethra is
located on the underside of the penis.
 In normal male, urethral opening is located at the tip of penis.
 This condition occurs during fetal development when urethra
does not fully close.

4. GRADES :
First – Degree (Anterior) Hypospadias : In this type, the urethral
opening is located near the tip of penis, but not at the very end.
Second – Degree (Midshaft) Hypospadias : The urethral opening
is along the shaft of penis, but not at the tip or near the base.
Third – degree (Penoscrotal) Hypospadias : The urethral opening
is located near the base of penis, closer to scrotum.
Fourth – degree (Perineal) Hypospadias : It is the most severe
form, where urethral opening is located in or behind the scrotum.

6. ETIOLOGY :
- Genetics
- Hormonal imbalance during fetal development
- Environmental Factors (exposure to factors like Endocrine
disrupting chemicals, pesticides, medications)
- Maternal Factors like older maternal age, obesity, Gestational
diabetes.
- Other medical conditions (disorders of sex development)

7. CLINICAL MANIFESTATIONS :
U – Urethral opening on the ventral side of Penis
D – Downward deflected stream of urine.
I – Incomplete foreskin development

8. DIAGNOSTIC STUDIES :
 History collection (Antenatal)
 Physical Examination
 Voiding Cystourethrogram
 Blood Examination to rule out hormonal imbalance
 Genetic Testing
 Ultrasound of Abdomen to check UTI.

9. MANAGEMENT :
Surgical Correction :
Goal of the surgery is to create a straight penis with urethral
opening at tip.
Surgical technique used depends on severity of condition.
a. Primary Repair – here surgeon straightens the penis & creates
a new urethral opening at tip.
b. Staged Repair – it involves multiple surgeries to gradually
reconstruct the penis and urethra.

11. Post – Operative :
 After the surgery, child is closely monitored for complications
like bleeding, infection or urinary problems.
 The penis is wrapped in a dressing & catheter is placed to drain
urine from bladder.
 Regular follow up visits are needed to monitor the healing
process and ensure proper urinary function.

12. THANK YOU