Hypospadias in Children

The majority of male babies are born with healthy, normal penises. However, some boys are born with hypospadias, a common urological problem that results in a penis with abnormal appearance and function. To correct this condition, paediatric urologists have developed several surgical methods. Use the information below to help guide a discussion with your child’s urologist.

What is Hypospadias?

Hypospadias is a condition where the opening of the urethra (meatus) is not located at the tip of the penis. Instead, the opening may appear anywhere along the underside of the penis. The most common type is called distal hypospadias, where the opening is near the tip. In more severe cases, called proximal hypospadias, the opening may be located at the base of the penis or within the scrotum.

In cases of severe hypospadias, a condition called chordee may also occur, causing the penis to curve downward significantly. It is estimated that hypospadias affects about 1 in every 200 males.

Symptoms of Hypospadias

• Urine stream does not go straight – may fall toward the feet
• Downward curvature of the penis (chordee)
• Penis appears small for the child’s age
• Undescended testicles in some cases (ambiguous genitalia)
• Hooded foreskin appearance – foreskin covers only the top
• Note: Babies with hypospadias should not be circumcised before surgical consultation.

Causes of Hypospadias

The penis develops between weeks 9 and 12 of pregnancy. During this time, a balance of male and female hormones is crucial for the proper formation of the urethra, foreskin, and testicular descent. Hormonal imbalances or disruptions during this stage of fetal development may lead to hypospadias.