Hypospadias

What is hypospadias?

Hypospadias is a condition in which the opening of a boy's urethra (called the meatus) is not in the correct spot. In a baby boy born with hypospadias, the opening can be located anywhere on the underside of the penis, from just below the tip of the penis all the way to the scrotum and, occasionally, below the scrotum.

Hypospadias is a congenital condition, which means a baby is born with this condition.

The condition can range from mild to severe, depending on where the opening is located.

• Distal or coronal: This is the mildest and most common type. It occurs when the opening of the urethra is near the head of the penis.
• Midshaft or middle: In this type, the opening of the urethra is located somewhere along the ventral shaft of the penis.
• Penoscrotal or scrotal: This is the most severe but least common type. In this type, the urethra is found where the penis and scrotum meet or in the scrotal area.

What are the signs and symptoms of hypospadias?

Hypospadias is usually diagnosed at birth when doctors notice the opening of the urethra is not in the right location. Often, the foreskin will be abnormal or incomplete.

Other symptoms may include:

• A curve or bend to the penis
• A foreskin that is not completely developed or extra skin on the top of the foreskin
• A downward spray of urine

What causes hypospadias?

Hypospadias develops in early pregnancy when the urethral folds do not unite on the midline all the way to the tip of the penis. This leaves the meatus further down on the glans or shaft. The foreskin also does not develop completely, often leaving a complete foreskin on the top side of the penis with much less or no foreskin on the underside of the penis.

About 1 out of every 100 boys is born with hypospadias. Risk factors may include hormones or genetics. Although doctors don't know the exact cause of hypospadias, it is a research focus for our team at Arkansas Children's.

How is hypospadias treated?

Most babies born with hypospadias will need surgery to fix the condition. Some babies with very mild forms of hypospadias may not need surgery. In most cases, surgery is done when your baby is between 6 and 12 months old.

There are many different surgical approaches used to correct hypospadias. Your medical team at Arkansas Children's is experienced in treating all forms of hypospadias and will work with you to come up with the best treatment plan for your child. This procedure rarely requires an overnight hospital stay.

During surgery, the surgeon may place a temporary, soft tube in the urethra to make it hold its new shape, which will be stitched in place for approximately one week. The baby may still wear diapers normally with this in place. This is removed after the first week of surgery in our outpatient clinic.