Hypospadias is a condition in which the meatus (the opening from which a boy urinates) is not located at the tip of the penis, but somewhere on the underside of the glans or the shaft of the penis. The severity of hypospadias is classified according to the location of the meatus on the penis. In a baby boy born with hypospadias, the opening can be located anywhere from just below the tip of the penis to the scrotum, and occasionally below the scrotum. A curvature of the penis (chordee) may also be associated with the hypospadias.
We know how to surgically correct hypospadias. We know less about why it occurs. Hypospadias is present in about 1out of every 100 boys. It is a congenital anomaly (present at birth). As the fetus develops, the urethral folds do not unite on the midline all the way to the tip of the penis, leaving the meatus (opening part) way down on the glans or shaft. The foreskin does not develop completely, typically leaving a complete foreskin on the top side of the penis and much less or no foreskin on the underside of the penis.
Each year, we treat more than 200 patients who have hypospadias. Usually, the surgical repair for hypospadias is done when your child is between 6 and 12 months old, when penile growth is minimal. There are different ways to correct hypospadias. The method depends on the surgeon, the location of the urinary opening of your child’s penis, and whether other conditions are present. The procedure is usually done on an outpatient basis and rarely requires an overnight hospital stay.
At birth, your child should not undergo circumcision, as the extra foreskin may be needed for the surgical repair. The surgeon will use a small piece of foreskin or tissue from another site to create a tube that increases the length of your son's urethra (tube that drains urine from the bladder). Extending the length of the urethra will allow it to open at the tip of the penis.
During surgery, the surgeon may place a catheter (tube) in the urethra to make it hold its new shape. The catheter may be stitched to the head of penis to keep it in place. The catheter will be removed one to two weeks after surgery. The stitches used during surgery dissolve on their own and will not have to be removed later.
The Children’s Hospital of Philadelphia pioneered the MAGPI technique for repairing hypospadias. While there are many different surgical approaches to correcting hypospadias, we strive to continue to find innovative techniques that will give boys the optimal repair.
Almost all children with hypospadias can be surgically corrected to look and function normally. In most cases your child’s penis will look like a normal circumcised penis with barely visible scars. This is especially true for more mild cases of hypospadias. However, there are some children for whom hypospadias is a more serious condition requiring extensive surgical reconstruction. We have particular expertise in working with these children. Our comprehensive team includes surgeons with years of experience operating on hypospadias, and a psychologist to help children and families cope with the effects of multiple procedures.
Through continued research and experience, the cosmetic and functional outcomes of boys with hypospadias have dramatically improved.
Reviewed by: Division of Urology
Date: March 2011