Everything You Need to Know About Hypospadias

Hypospadias is a congenital birth defect found in male infants that affects how the penis functions. The condition usually forms during weeks 8-14 of pregnancies and can affect 1 in 300 boys. Today we’ll be talking about hypospadias and answer the most common questions parents ask when their baby is diagnosed with this condition.

What is hypospadias?

Hypospadias is a condition wherein the urethra is not located in the tip of the penis. The opening can be found anywhere from the base of the penis and even to the scrotum. There are  different types of hypospadias which can range from being relatively minor to a severe medical condition. The different types of hypospadias are:

  • Glanular The urethra is found right around the penis glans.
    • Subcoronal: The urethra is found at the base of the penis glans.
  • Penile shaft : distal shaft, mid shaft and proximal shaft The urethra forms along the shaft of the penis.
    • Penoscrotal: The urethra is located where the penis and scrotum are connected.
  • Scrotal or perineal:  the urethral opening is n the scrotal skin

Aside from having urethral problems, hypospadias can also be associated with a curved penis. Hypospadias can lead to improper urination where an infant may be required to sit in order to avoid spraying urine. If the condition is left untreated, several problems will arise later in adulthood like difficulty in urinating as well as having sexual intercourse.

What causes hypospadias?

It’s still relatively unknown to paediatricians what causes hypospadias. In most cases, the condition is believed to be caused by a number of different factors such as:

  • Fertility treatments: Women who undergo fertility treatments can increase the risk of the baby’s development of hypospadias
  • Age and weight: Obesity is believed to influence hypospadias development in male infants. Mothers who are at the age of 35 or older with significantly high body weight are prone to giving birth to a baby with hypospadias.
  • Taking hormones. Women who took hormones before or during pregnancy were reportedly found to have increased risk of having a baby with hypospadias.

Genetics also appears to play a role in hypospadias development in male infants. The chances of a baby boy developing the condition are much higher if the family has a history of hypospadias.

How is hypospadias treated?

In order to treat hypospadias, surgery is required. The surgeon will first examine if your baby is healthy enough to undergo a surgical procedure. The goal of any type of hypospadias surgery is to correct the shaft of the penis and make a normal, straight urinary channel that ends in the tip of the penis. The operation lasts for around 90 minutes, but in severe cases it may require multiple visits to the hospital.

If the infant has a mild hypospadias and he has a good stream of urine, an operation might not be necessary. Ideally, the procedure is done between 6 and 12 months of age Occasionally earlier operation is necessary if the urethral opening is very narrow and restricting the flow of urine.  If required for a baby less than 6 months old a minor procedure is performed opening under a short genreral anaesthetic to enlarge the urethral opening.. But don’t worry, hypospadias can be treated in children of any age and in some cases, even adults. Successful surgery is aimed to correct hypospadias for life. In the majority of those affected the penis can be restored to normal condition (both in looks and functionality) without difficulty urinating or performing exual activity.

Depending upon the extent of hypospadias repair,a small tube called a catheter or stent may be left in the penis for a few days to prevent the urine from coming into contact with the wound. This is to reduce complications during the recovery process. Antibiotics are prescribed before the catheter is removed to assiste successful healing.

Are there any complications associated with hypospadias surgery?

Complications in male infants who undergo hypospadias surgery is less than 1 in 10 babies. One of the most common problems after the surgery is a fistula (an abnormal hole that forms in another part of the penis. Scars can also form in the urethral opening after the procedure which can interfere with urination. If the infant’s urine is spraying in different directions or if the urine stream is slow, a trip to the pediatric urologist is required to correct the condition.

Usually, the complications appear within the first few months after surgery. These problems can be easily fixed after the tissues have fully healed from the first operation (which takes around 6 months). Your baby’s surgeon will provide you with a couple of tips on how to care for your baby’s penis after surgery. Most operations are a success after the the first ooperationt, but do know that it’s not uncommon for your baby to undergo a second procedure to fully correct and achieve the best cosmetic result.

Conclusion

Many parents ask if mild forms of hypospadias need to be corrected. While it can be hard to predict problems once a baby enters adulthood, it’s generally a good idea to have the condition corrected. This will prevent further complications from developing later in life. Don’t be hesitant to ask your baby’s paediatric surgeon if you have any questions about hypospadias.