BACK TOTOP Browse A-ZSearchBrowse A-ZABCDEFGHIJKLMNOPQRSTUVWXYZ0-9 E-mail FormEmail ResultsName:Email address:Recipients Name:Recipients address:Message: Print-FriendlyBookmarksbookmarks-menuHypospadiasHypospadias is a birth (congenital) defect in which the opening of the urethra is on the underside of the penis. The urethra is the tube that carries urine and semen through the penis and outside the body. In males, the opening of the urethra is normally at the end of the penis. Causes Hypospadias occurs in about 1 in 200 newborn boys in the United States. The cause is often unknown. Certain factors may be associated with the condition, such as:Family history Genetic factors that affect the development of the urethra Maternal age over 35 Maternal overweight or obesity Premature birth Low birth weightOther factors, such as exposure to certain hormones or substances in the environment may also play a role. Symptoms Symptoms depend on how severe the problem is. Most often, boys with this condition have the opening of the urethra near the tip of the penis on the underside. More severe forms of hypospadias occur when the opening is in the middle or base of the penis. Rarely, the opening is located in or behind the scrotum.This condition may cause a downward curve of the penis during an erection. Erections are common in infant boys.Other symptoms include:Abnormal spraying of urine (this can make it difficult to urinate while standing) Foreskin that makes the penis looks like it has a "hood" Some boys with hypospadias have one or both testicles that have not moved down into the scrotum (undescended testicle). Exams and Tests This problem is usually diagnosed soon after birth during a physical exam. Imaging tests may be done to look for other congenital defects.Infants with hypospadias who have one or both testicles that have not moved down into the scrotum may need genetic testing (karyotyping) to check for genetic conditions.KaryotypingKaryotyping is a test to examine chromosomes in a sample of cells. This test can help identify genetic problems as the cause of a disorder or diseas...Read Article Now Book Mark Article Treatment The goals of treatment are:To ensure that urine and semen can pass normally through the urethra To have the opening of the urethra at or near the tip of the penis To correct any curvature so the penis is straight during an erectionInfants with hypospadias should not be circumcised. The foreskin should be kept intact for use in later surgical repair.CircumcisedCircumcision is the surgical removal of the foreskin of the penis.Read Article Now Book Mark Article In most cases, surgery is done before the child starts school. Most urologists recommend repair when the child is between 6 and 12 months and before 18 months old. During the surgery, the penis is straightened and the opening is corrected using tissue grafts from the foreskin. For more complex cases, the repair may require several surgeries.In some cases, if the hypospadias is very mild and there is no curve in the penis, surgery may be optional. However, even very mild cases may need to be repaired to prevent possible future problems. It's important to discuss the benefits and risks of treatment with your health care provider when deciding what is best for your child. Outlook (Prognosis) Results after surgery are most often good. In some cases, more surgery is needed to correct fistulas (abnormal connection between the urethra and skin), narrowing of the urethra, or a return of the abnormal penis curve.FistulasA fistula is an abnormal connection between two body parts, such as an organ or blood vessel and another structure. Fistulas are usually the result ...Read Article Now Book Mark Article Most males can have normal adult sexual activity. When to Contact a Medical Professional Contact your provider if your son has:A curved penis during an erection Opening to the urethra that is not on the tip of the penis Incomplete (hooded) foreskinOpen ReferencesReferencesChan Y-M, Hannema SE, Achermann JC, Hughes IA. Disorders of sex development. In: Melmed S, Auchus, RJ, Goldfine AB, Koenig RJ, Rosen CJ, eds. Williams Textbook of Endocrinology. 14th ed. Philadelphia, PA: Elsevier; 2020:chap 24.Elder JS. Anomalies of the penis and urethra. In: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020:chap 559.Long CJ, Zaontz MR, Canning DA. Hypospadias. In: Partin AW, Domochowski RR, Kavoussi LR, Peters CA, eds. Campbell-Walsh-Wein Urology. 12th ed. Philadelphia, PA: Elsevier; 2021:chap 45.AllVideoImagesTogRelated Information Hypospadias repair(Surgery)Penis(Special Topic)Hypospadias repair - discharge (Discharge) Review Date: 1/1/2023 Reviewed By: Kelly L. Stratton, MD, FACS, Associate Professor, Department of Urology, University of Oklahoma Health Sciences Center, Oklahoma City, OK. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. Editorial update 12/18/2023. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. 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HypospadiasHypospadias is a birth (congenital) defect in which the opening of the urethra is on the underside of the penis. The urethra is the tube that carries urine and semen through the penis and outside the body. In males, the opening of the urethra is normally at the end of the penis. Causes Hypospadias occurs in about 1 in 200 newborn boys in the United States. The cause is often unknown. Certain factors may be associated with the condition, such as:Family history Genetic factors that affect the development of the urethra Maternal age over 35 Maternal overweight or obesity Premature birth Low birth weightOther factors, such as exposure to certain hormones or substances in the environment may also play a role. Symptoms Symptoms depend on how severe the problem is. Most often, boys with this condition have the opening of the urethra near the tip of the penis on the underside. More severe forms of hypospadias occur when the opening is in the middle or base of the penis. Rarely, the opening is located in or behind the scrotum.This condition may cause a downward curve of the penis during an erection. Erections are common in infant boys.Other symptoms include:Abnormal spraying of urine (this can make it difficult to urinate while standing) Foreskin that makes the penis looks like it has a "hood" Some boys with hypospadias have one or both testicles that have not moved down into the scrotum (undescended testicle). Exams and Tests This problem is usually diagnosed soon after birth during a physical exam. Imaging tests may be done to look for other congenital defects.Infants with hypospadias who have one or both testicles that have not moved down into the scrotum may need genetic testing (karyotyping) to check for genetic conditions.KaryotypingKaryotyping is a test to examine chromosomes in a sample of cells. This test can help identify genetic problems as the cause of a disorder or diseas...Read Article Now Book Mark Article Treatment The goals of treatment are:To ensure that urine and semen can pass normally through the urethra To have the opening of the urethra at or near the tip of the penis To correct any curvature so the penis is straight during an erectionInfants with hypospadias should not be circumcised. The foreskin should be kept intact for use in later surgical repair.CircumcisedCircumcision is the surgical removal of the foreskin of the penis.Read Article Now Book Mark Article In most cases, surgery is done before the child starts school. Most urologists recommend repair when the child is between 6 and 12 months and before 18 months old. During the surgery, the penis is straightened and the opening is corrected using tissue grafts from the foreskin. For more complex cases, the repair may require several surgeries.In some cases, if the hypospadias is very mild and there is no curve in the penis, surgery may be optional. However, even very mild cases may need to be repaired to prevent possible future problems. It's important to discuss the benefits and risks of treatment with your health care provider when deciding what is best for your child. Outlook (Prognosis) Results after surgery are most often good. In some cases, more surgery is needed to correct fistulas (abnormal connection between the urethra and skin), narrowing of the urethra, or a return of the abnormal penis curve.FistulasA fistula is an abnormal connection between two body parts, such as an organ or blood vessel and another structure. Fistulas are usually the result ...Read Article Now Book Mark Article Most males can have normal adult sexual activity. When to Contact a Medical Professional Contact your provider if your son has:A curved penis during an erection Opening to the urethra that is not on the tip of the penis Incomplete (hooded) foreskinOpen ReferencesReferencesChan Y-M, Hannema SE, Achermann JC, Hughes IA. Disorders of sex development. In: Melmed S, Auchus, RJ, Goldfine AB, Koenig RJ, Rosen CJ, eds. Williams Textbook of Endocrinology. 14th ed. Philadelphia, PA: Elsevier; 2020:chap 24.Elder JS. Anomalies of the penis and urethra. In: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020:chap 559.Long CJ, Zaontz MR, Canning DA. Hypospadias. In: Partin AW, Domochowski RR, Kavoussi LR, Peters CA, eds. Campbell-Walsh-Wein Urology. 12th ed. Philadelphia, PA: Elsevier; 2021:chap 45.