What is hypospadias? — Hypospadias is the medical term for a type of birth defect that affects the penis. In boys born with this birth defect, the tube that carries urine from the bladder to the outside of the body, called the “urethra,” does not form normally. As a result, the hole that urine comes out of—called the “urethral opening”—is in the wrong place
In a normal penis, the urethral opening (the hole) is at the tip of the penis. In a penis with hypospadias the hole can be close to the tip, somewhere along the shaft of the penis, or down by the testicles. If the condition is severe and is not corrected, it can cause urine to flow in an unusual direction. Because of this boys with severe hypospadias that are not corrected have to sit down to urinate.
Severe hypospadias can also harm a boy’s ability to get a woman pregnant when he grows up. That’s because severe hypospadias can affect the erection of the penis and how sperm are delivered into the vagina during sex.
Boys born with hypospadias sometimes also have an undescended testicle. That’s when one of the boy’s testicles stays in the belly instead of dropping down into the sac between his legs (called the scrotum).
Will my son need tests? — Maybe. If your son has hypospadias, his healthcare team probably found it during the exam they did right after your son was born. Sometimes after finding hypospadias, doctors order blood tests to find out if the cause is a hormone- or gene-related problem. They also sometimes order an imaging test called an ultrasound if they cannot locate the testicles. The ultrasound can show where the testicles are and whether they look normal.
How is hypospadias treated? — Treatment is not always needed. Boys with mild hypospadias can often urinate normally, although their urine stream might point in a different direction than it does in other boys. Boys with mild hypospadias can usually also have sex normally when they grow up.
In boys with more severe hypospadias, the main treatment is surgery to create a new urethra that has an opening in the right place. This surgery is usually done when the boy is about 6 months old. Some boys need more than one surgery to repair the hypospadias.
In boys who might need surgery, it’s a good idea to hold off on circumcision. That way, surgeons can use the skin that would normally be removed during a circumcision to rebuild parts of the penis.