Hypospadias: What you should know

Hypospadias is a birth defect where the meatus (the opening of the penis where urine and sperm come out) isn’t on the tip of the penis. Instead, the meatus appears on the underside of the penis. In minor forms of the condition, the meatus is still on the head of the penis, just a little below the tip. In more severe forms, the meatus may appear as far back as the scrotum.

Affecting every 1 in 200 males, hypospadias is the most common birth defect in boys. Fortunately, pediatric urologists can treat the condition with minor surgical procedures.

What causes hypospadias?

Hypospadias can occur while the urinary tract is developing during weeks 9 to 12 of pregnancy. The exact cause of the condition is unknown, though it may be related to problems with hormones.

How does hypospadias affect my son’s health?

“If hypospadias is very mild, it might have no impact on the health,” says Micah Jacobs, M.D., pediatric urologist at Children’s Health℠. 

Dr. Jacobs says hypospadias can affect a boy’s ability to urinate or, later in life, have a child. Urine may come out as a spray or require a boy to sit down to urinate.

Hypospadias can also cause the penis to curve downward, making penis function more difficult. Later in life, when a patient has an erection, the curve can become more pronounced, affecting sexual function and fertility.

How is hypospadias diagnosed?

“Usually, hypospadias is diagnosed right at birth as part of the genital exam,” says Dr. Jacobs.

All newborns receive a genital exam in the hospital as part of their newborn exam. These exams help ensure your child is healthy.

How is hypospadias treated?

Dr. Jacobs says that mild hypospadias may not need surgical treatment at all. However, if it affects penis function, your son may need surgery. Pediatric urologists suggest your son has surgery between 6- and 18-months-old.

For mild versions of hypospadias, a single outpatient surgery can correct problems, relocating the meatus to the tip of the penis. Your child will have a catheter for urine to come out of for a week, but then should have healthy penis function.

More severe forms may require two hypospadias surgeries: one to correct the curvature of the penis and one to move the meatus to the tip of the penis.

Though the penis is a sensitive area, causing parents anxiety about future health issues, the vast majority of boys with hypospadias will grow up with no problems.

“It’s a fixable problem,” says Dr. Jacobs. “Most children who have hypospadias could grow up and never know they had surgeries for it.”

In rare instances, boys may need future surgeries to straighten out the penis or to correct a fistula (an opening in the urinary tract). However, these instances are rare.

Learn more

If your child has hypospadias, our Urology department at Children’s Health can help.