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Hypospadias

Identifying and Treating This Male Genital Anomaly

By Donna Smith

The first thing most new parents do is count all of Baby's fingers and toes. However, not many would think to check their newborn son's penis for hypospadias, a condition that occurs in approximately one in 250 births.

"Hypospadias is a condition in which the end of the urethra (the tube in the penis that males urinate through) is not located at the tip of the penis," says Dr. Earl Cheng, attending physician in the Department of Urology at the Children's Memorial Hospital in Chicago, Ill. "The cause of this condition is not known and is usually an isolated congenital defect that is not associated with any other defects in other organs."

Hypospadias varies in severity from mild – opening near the glans of the penis – moderate – on the penile shaft – to severe – on the base of the penis or further back. In about two-thirds of all cases the defect is located near the end of the penis, where the opening is either in the glans (the "head" of the penis) or just below the glans on the underside. "In more severe forms of hypospadias, the opening is located further down on the penile shaft or in the scrotum," says Dr. Cheng.

How hypospadias will affect a child throughout life depends on the severity. "In the most severe cases, the patient may not be able to deliver sperm during coitus and have some minimal problems with urinating while standing up," says Dr. Hiep T. Nguyen, M.D., FAAP, pediatric urologist and assistant professor of urology and pediatrics at USCF Children's Hospital in San Francisco, Calif. "In the majority cases, it does not affect growth or development."

Hypospadias is also associated with a downward curvature of the penis. "This is known as 'chordee,'" says Dr. Cheng. "In general, the more severe the hypospadiac defect, the more severe the chordee."

Want to see more?

• Making the Cut: Rethinking Newborn Circumcision
• The AAP's Circumcision Recommendations
• Newborn Circumcision: A Parent's Guide to Proper Care
• Talk about it!

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