Hypospadias is a birth defect in boys in which the urethra, the tube through which urine travels from the bladder to outside the body, does not develop properly.  This condition affects about one in every 250-300 male babies making it one of the more common male birth defects.  During pregnancy, the urethra begins as an open channel that will gradually close as the baby develops.  In baby boys born with hypospadias, the opening of the urethra is discovered to have formed in another location – on the shaft of the penis or on the scrotum – instead of on the tip of the penis where it is supposed to be. If hypospadias is not treated it can lead to problems later in life such as requiring a man to have to sit to urinate or difficulties with sexual intercourse.

Other features of hypospadias seen in males may include:

·Chordee or where the head of the penis curves downward or upward at the junction of the head and shaft of the penis. This curvature is most noticeable during an erection.

·10% of male babies with hypospadias will have one testicle that does not fully descend into the scrotum.

·The foreskin which covers the head of the penis is incompletely developed.

Causes of hypospadias

The exact cause of hypospadias is unknown but there does seem to be a 21 percent more likelihood of it happening if another close family member such as the father or a brother was born with the same defect. 

During the first eight weeks of pregnancy, male and female genitalia are similar.  During the eighth week is when the male penis begins to develop with hypospadias occurring between the weeks nine and 12.

There are certain factors of the mother that may increase the risk of hypospadias developing:

·Obesity

·Over the age of 35

·Using fertility treatment to help with conception.  It is theorized that when a woman is exposed to progesterone used during the fertilization process, it may increase the risk.

·Any use of other hormones before or during pregnancy included pesticide exposure.

·Smoking

Diagnosing hypospadias

Shortly after a male baby is born is when hypospadias is diagnosed.  Doctors will check for hypospadias in all male babies after birth as the abnormality is easily confirmed.  Once the diagnosis is made, the family will be referred to a pediatric urologist who can treat the baby.

Treatment of hypospadias

The way to treat hypospadias is with surgery. Surgeons have been treating hypospadias since the late 1800’s.  The goal is to make a normal, straight penis with a urinary channel that ends at or near the tip.  The surgery involves four steps:

·Straightening the shaft

·Making the urinary channel

·Positioning the hole in the head of the penis

·Circumcising or reconstructing the foreskin

A urologist can usually correct the condition of the baby sometime between 6 to 18 months of age.  The surgery is performed at an early age as it is easier to take care of the surgery site and with it being corrected under a general anesthetic.  Also performing the surgery at a very young age reduces any psychological trauma they may experience at an older age. 

The surgery is done to correct curvature of the penis and to place the opening of the urethra in the correct spot. After the surgery, the baby may have a small catheter (tube) to help drain urine which may stay in place for a few days to two weeks.  Antibiotics are also prescribed to reduce the risk of infection along with pain medications to lessen discomfort. 

Are there ways to reduce hypospadias?

There are no guarantees but there are a few things a woman can do to possibly reduce the risk of hypospadias by practicing healthy habits such as:

·Maintaining a healthy body weight

·Obtaining a 400 to 800 mcg of folic acid each day

·Refrain from smoking

·Have regular prenatal checkups throughout the pregnancy

Outlook for hypospadias

Fortunately, the outlook for male babies who are born with hypospadias is good.  There tends to be few complications after surgery as long as the parents are taking good care of the surgical site and are keeping regular doctor follow-up appointments.  The surgical repair for hypospadias will last a lifetime leading to normal, healthy functioning of the penis.