Hypospadias

Hypospadias is a condition where the urethra and foreskin don’t develop properly in a baby’s penis. The urethra is the tube that carries pee (urine) and semen (ejaculate) through the penis and outside of the body. The foreskin is the skin that normally covers the head of the penis completely in uncircumcised people.

Early in a fetus’s development, the urethra starts as an open channel. The channel closes to form a complete tube as a fetus develops before birth. The meatus is the opening at the end of the urethra. It’s usually in the head of or at the tip of the penis. It’s where semen and pee exit the body.

In a baby with hypospadias, the urethral tube doesn’t close all the way, causing the meatus to form below the tip of the penis. It may exist anywhere along the shaft of the penis, in the scrotum or even lower, near the butthole (anus). The scrotum is the pouch of skin behind the penis that usually holds the testicles. The anus is where poop exits the body.

Hypospadias is a congenital condition, which means it’s present at birth. It can range from mild to severe. Without treatment, problems can develop later in life, including difficulty peeing and difficulties having sexual intercourse.

Is hypospadias a serious problem?

Hypospadias can range from very mild to severe. A surgeon may not need to repair mild cases. But in most cases, hypospadias requires surgery.

What are the types of hypospadias?

Healthcare provides categorize the type of hypospadias by where the urethra opens:

• Glanular (balanic). Glanular hypospadias is when the meatus or urethral opening is in the head of the penis, but not all the way at the tip. It’s the mildest type of hypospadias.
• Coronal. Coronal hypospadias is the most common form of hypospadias. It’s when the meatus is just below the head of the penis or where the head of the penis meets the shaft.
• Midshaft. Midshaft hypospadias occurs halfway down the penis shaft.
• Penoscrotal. Penoscrotal hypospadias occurs where the penis and scrotum meet.
• Scrotal/Perineal. Scrotal and perineal hypospadias are the most severe forms of hypospadias. The urethra opens on or below the scrotum.

How common is hypospadias?

Hypospadias is common. It occurs in approximately 1 of every 150 to 300 children assigned male at birth (AMAB). It’s the second-most common congenital condition that affects children AMAB, behind undescended testicles. The milder forms happen more often than the severe forms.

The rate of hypospadias seems to be increasing in Western cultures. Researchers suspect there may be a link between rising rates of hypospadias and the increased use of certain chemicals, pollutants and pesticides.