Hypospadias: A-to-Z Guide from Diagnosis to Treatment to Prevention

Usually the opening of the penis is located right at the tip.

What is it?

Hypospadias is the name of the condition in which the opening of the penis (the meatus) is located some place other than the tip.

Who gets it?

Hypospadias occurs in about 1 in 250 boys, though it seems to be becoming more common. Those exposed to estrogens or to endocrine disrupting chemicals such as PCBs are at higher risk.

These same boys sometimes have undescended testicles, inguinal hernias, or hydroceles.

What are the symptoms?

The type of hypospadias depends on the location of the opening. There are several variants: glanular (on the head of the penis), coronal (on the ridge), subcoronal (below the ridge), midpenile (on the shaft), penoscrotal (between the penis and the scrotum), scrotal, and perianal hypospadias (near the anus). There is also a variant with a large, fish-mouth shaped opening called megameatal hypospadias.

It can cause urinary problems. Also, it is often associated with abnormal penis angulation called chordee.

Is it contagious?

No

How long does it last?

It lasts until corrected.

How is it diagnosed?

The diagnosis is usually made on the physical exam.

How is it treated?

Treatment involves surgical correction. This is usually done between about 6 and 18 months of age, usually on an outpatient basis. In some boys the hypospadias is so mild that it does not need to be treated.

Newborn circumcision should be avoided in boys with obvious hypospadias. Sometimes it can occur with a full foreskin (usually a glanular or coronal hypospadias) and is only recognized at the time of circumcision. In those cases, the hypospadias repair generally is not complicated by having done a circumcision (Journal of Urology, 2006, 176(1), 296-298).

How can it be prevented?

Often it cannot be prevented. Avoiding exposure to estrogens and to endocrine disruptors such as dioxin, PCBs, DDT, and some other pesticides can prevent some cases. Many chemicals, particularly pesticides and plasticizers, are suspected endocrine disruptors based on limited animal studies.