Birth Defects Genital Urinary Tract Hypospadias

Birth defects affecting the genitals develop during pregnancy, and can affect both urinary and sexual function. Hypospadias is a condition affecting males in which the urethral opening, or penile meatus, is located on the underside of the penis rather than at the tip. If left untreated, this condition can lead to incontinence and later difficulties with sexual function.

Hypospadias Symptoms

Symptoms of hypospadias include:

  • Abnormal formation of the foreskin (covering only the top half of the penis)
  • Downward curvature of the penis, known as chordee
  • Urethral opening not located at the tip of the penis.

Hypospadias can present at varying levels of severity. Doctors determine severity based on how far the urethral opening is from its normal location. In less severe cases, the urethral opening is on the underside of the penis, near the tip. However, in more severe cases, the opening can occur along the underside of the shaft, closer to the body.

This opening can be anywhere from the end of the shaft to the base (in more severe cases). These are classified by location as:

  • Anterior: closest to the tip
  • Middle: along the mid-shaft
  • Posterior: closest to the base.

Causes of Hypospadias

Hypospadias occurs during fetal development. Its causes are not fully understood, but hormones during pregnancy influence the development of male and female sexual organs and the urinary tract. If the hormones do not perform normally, these structures can form abnormally. In hypospadias, the abnormality includes incomplete closure of the urethral tissue on the underside of the penis.

Though it is not considered a genetic condition, development of hypospadias does seem to be affected by genetic factors, as it tends to run in families.

Hypospadias Treatment

Hypospadias is treated surgically. Hypospadias surgery varies somewhat based on the severity level and the location of the opening. The surgical procedure can involve several steps. The abnormal urethral opening is closed, which may involve skin grafting. The urethra is reconstructed and lengthened if necessary, particularly in cases where the opening is somewhere along the shaft. The procedure is performed under general anesthesia.

Hypospadias repair should be performed early in life, and before circumcision, as tissue from the foreskin is needed to complete the surgical repair in some cases. Hypospadia surgery is most often successful. In some cases, however, further surgeries may be needed. After surgery, the doctor may prescribe topical antibiotics or pain medications to prevent infection and relieve post-surgical discomfort.

Resources

Children’s Hospital Boston. (n.d.). Hypospadias. Retrieved April 20, 2010, from: http://www.childrenshospital.org/az/Site1134/mainpageS1134P0.html.

Cornell University Department of Urology. (n.d.). Hypospadias. Retrieved April 20, 2010, from: http://www.cornellurology.com/pediatrics/hypospadias.shtml.

Mayo Clinic. (n.d.). Hypospadias. Retrieved April 20, 2010, from: http://www.mayoclinic.com/health/hypospadias/DS00884.

Medline Plus. (n.d.). Hypospadias. Retrieved April 20, 2010, from: http://www.nlm.nih.gov/medlineplus/ency/article/001286.htm.