The vast majority of newborn males are born without any defects, but a few might born with a birth defect. Hypospadias is a birth defect that affects boys. Fortunately, many boys affected can be successfully treated once they are diagnosed.
What is hypospadias?
Most boys are born with a penis that looks normal and works well. Some boys are born with a common condition called hypospadias. Hypospadias is a congenital (present at birth) problem affecting a boy’s penis.
It is a combination of three separate problems:
• the hole through which urine passes (meatus) is not at the tip of the penis
• the foreskin is gathered at the back of the penis with none at the front
• the penis may be bent when stiff.
The position of the meatus varies. In some boys, the hole is only a small distance away from the tip of the penis whereas, in others it is at the base of the penis, in the scrotum or behind the scrotum.
What causes hypospadias?
About one in every 300 boys has hypospadias, although this figure seems to be rising. We do not know what causes hypospadias. More research is needed to learn more about the causes.
The key steps in forming the penis take place between weeks 9 and 12 of pregnancy. During this time, male hormones tell the body to form the urethra and foreskin. There is speculation that hypospadias may be caused by problems with hormones.
Hypospadias can be associated with other conditions such as inguinal hernia or undescended testicles. About 8 in 100 boys with hypospadias also have a testicle that has not fully dropped into the scrotum.
What are the signs and symptoms of hypospadias?
The appearance of the penis is the most obvious sign of hypospadias but also, urine will not pass through the tip of the penis. This means peeing standing up may not be possible. Later on, having an adequate erection and having sex may be difficult.
How is hypospadias diagnosed?
Hypospadias is usually diagnosed by clinical evaluation of the appearance of the penis and the symptoms reported by the parents. Most boys are assessed when a few months old, so that treatment can be planned for when the child is between six months and a year old. It is important that circumcision does not take place as the foreskin is needed during the operation.
How is hypospadias treated?
Although hypospadias does not cause any immediate problems, and is not life threatening, it means that peeing standing up may not be possible and, later on, having an adequate erection and having sex may be difficult.
Hypospadias is fixed with surgery. The aim of the operation is to straighten the penis, move the meatus to the tip of the penis and to carry out a circumcision by removing the excess foreskin.
A successful repair should last a lifetime. It will also be able to adjust as the penis grows at puberty.
Is hypospadias passed through genes?
In about 7 out of 100 children with hypospadias, the father also had it. The chance that a second son will be born with hypospadias is about 12 out of 100. If both father and brother have hypospadias, the risk in a second boy increases to 21 out of 100.
Conclusion
Hypospadias is a birth defect that affects boys. This disorder can be successfully treated by a surgical operation. Treatment is usually done at age six months to six years – but it can be done at other ages. Having hypospadias does not usually affect a man’s fertility even if it is not corrected. If hypospadias is not treated, passing urine and having sex might be problematic. Because of this it is strongly recommended that all boys with hypospadias should be treated by an experienced surgeon.
Ask Your Dr is a health education column and is not a substitute for medical advice from your physician. The reader should consult his or her physician for specific information concerning specific medical conditions. While all reasonable efforts have been made to ensure that all information presented is accurate, as research and development in the medical field are ongoing, it is possible that new findings may supersede some data presented.
Dr Brett Hodge MB BS DGO MRCOG is an obstetrician/Gynaecologist and Family Doctor with over thirty-five years in clinical practice. Dr Brett Hodge has a medical practice in The Johnson Building in The Valley (Tel: 264 497 5928).
