Key takeaways: Hypospadias is a condition present at birth in which the opening of the urethra is on the underside of the penis instead of the tip. The CDC estimates it affects about 1 in every 200 boys born in the U.S. Circumcision is usually postponed because the foreskin may be used in repair. Many cases are repaired with surgery, often in the first 18 months.
Hypospadias is one of the most common birth differences in boys. Most can be repaired with excellent results.
What It Is
The urethra carries urine out of the body. In hypospadias, the opening (meatus) is located somewhere along the underside of the penis, or even near the scrotum.
Types
- Distal: near the head of the penis. Most common and mildest.
- Midshaft: along the shaft.
- Proximal: near the scrotum or perineum. Less common and more complex.
Other Features
- Hooded foreskin: incomplete foreskin on the underside.
- Chordee: a downward curve of the penis.
- Undescended testicles can occur alongside, especially with more severe types.
Circumcision
If your son has hypospadias, the AAP and pediatric urologists advise against newborn circumcision, because the foreskin may be needed for repair.
Treatment
- Mild cases may not need surgery if urine flows straight and there’s no curve.
- Surgery moves the opening to the tip, straightens the penis if needed, and creates a normal appearance. It’s often done when babies are between about 6 and 18 months, though timing varies.
- Most repairs are done as outpatient surgery.
After Surgery
Your baby may have a small catheter or stent for several days. Follow your surgeon’s instructions on bathing, diapering, and pain relief. Some children need further surgery for complications, like a small hole (fistula).
When More Testing Is Needed
Severe hypospadias, especially with undescended testicles, may need further evaluation, including genetic or hormone testing.
Call your surgeon or doctor if your baby: can’t urinate, has a fever, has increasing redness or swelling, or has bleeding after surgery.
The Bottom Line
Hypospadias is common and very treatable. Postpone circumcision and see a pediatric urologist to plan care.
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Sources
- Centers for Disease Control and Prevention. About hypospadias. https://www.cdc.gov/birth-defects
- Urology Care Foundation. Hypospadias. https://www.urologyhealth.org
- American Academy of Pediatrics. Hypospadias. HealthyChildren.org. https://www.healthychildren.org
This article is for general education and is not a substitute for individualized medical advice. Always talk with your baby’s health care provider or your own provider about your specific situation. If you think your baby or you may have a medical emergency, call 911.
