what is Hypospadias?
Hypospadias is a birth (congenital)
defect in which the opening of the urethra is on the underside of the
penis. The urethra is the tube that drains urine from the bladder. In
males, the opening of the urethra is normally at the end of the penis.
Causes
Hypospadias occurs in up to 4 in 1,000 newborn boys. The cause is often unknown.
Sometimes, the condition is passed down through families.
Symptoms
Symptoms depend on how severe the problem is.
Usually, boys with this condition have the opening of the urethra near the tip of the penis on the underside.
More
severe forms of hypospadias occur when the opening is in the middle or
base of the penis. Rarely, the opening is located in or behind the
scrotum.
This condition may cause a downward curve of the penis during an erection. Erections are common in infant boys.
Other symptoms include:
- Abnormal spraying of urine
- Having to sit down to urinate
- Foreskin that makes the penis looks like it has a "hood"
Exams and Tests
This
problem is almost always diagnosed soon after birth during a physical
exam. Imaging tests may be done to look for other congenital defects.
Treatment
Infants with hypospadias should not be circumcised. The foreskin should be kept for use in later surgical repair.
Surgery
is usually done before the child starts school. Today, most urologists
recommend repair before the child is 18 months old. Surgery can be done
as young as 4 months old. During the surgery, the penis is straightened
and the opening is corrected using tissue grafts from the foreskin. The
repair may require multiple surgeries.
Outlook (Prognosis)
Results after surgery are most often good. In some cases, more surgery is needed to correct fistulas or a return of the abnormal penis curve.
Most males can have normal adult sexual activity.
When to Contact a Medical Professional
Call your health care provider if your son has:
- A curved penis during an erection
- Opening to the urethra that is not on the tip of the penis
References
Kraft KH, Shukla AR, Canning DA. Hypospadias. Urol Clin North Am. 2010. 37:167-81.
Elder JS. Anomalies of the penis and urethra. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, eds. Nelson Textbook of Pediatrics. 19th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 538.
Snodgrass WT. Hypospadias. In: Wein AJ, ed. Campbell-Walsh Urology. 10th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 130.
source :
http://www.nlm.nih.gov/medlineplus/ency/article/001286.htm
