Adult hypospadias

Hypospadias is an abnormal opening of the urethra (the tube that carries urine from the bladder and also the semen to the outside of the body is called the urethra) that has a hole (meatus) on the underside of the penis and not at the tip.

The meatus may also be found from the middle of the penile shaft to the base of the penis, or sometimes even within the scrotum.

Hypospadias is diagnosed right after birth, to correct it, surgery is required once the child is one year old.

Around 80% of the children born with this defect have distal hypospadias. In some of these cases, the penis is curved downward slightly, this condition is called “chordee”.

• Opening of the urethra at a location other than the tip of the penis,
• Downward curve of the penis,
• Hooded appearance of the penis because only the top half of the penis is covered by the foreskin,
• Abnormal spraying during urination

Hypospadias is a birth defect. Forming of the penis takes place between 9 to 12 weeks during pregnancy. During this period, certain hormones stimulate the development of the urethra and foreskin. Hypospadias might have caused due to hormonal problems.

In most cases, the actual cause is unknown. Sometimes, it may be genetic.

• Family history,
• genetics,
• maternal age over 35,
• exposure to certain substances during pregnancy may cause this condition such as pesticides or industrial chemicals, but this is not confirmed.

Complications may arise if it is not treated, like

• abnormal appearance of the penis,
• unable to learn how to use the toilet,
• abnormal curvature of the penis.

Doctors typically diagnose hypospadias just after the baby is born. With this condition, not only the meatus is in the wrong place but also the foreskin is not formed completely on its underside. This results in the “dorsal hood” that leaves the penis exposed at the tip.

You should consult your doctor if you notice

• that your child's urethral opening is not at the tip of his penis,
• if his penis curves downward, or
• if his foreskin is not fully developed.

Hypospadias is fixed with surgery only, the goal of the surgery 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 meatus at the tip of the penis,
• reconstructing the foreskin.

Mostly hypospadias is corrected in a single surgery, some forms of hypospadias may require more than one surgery to correct the defect.

If the urethral opening is near the base of the penis, then the doctor may use tissue grafts from the foreskin or from the inside of the mouth to reconstruct the urinary channel in the proper position, correcting the hypospadias.

These surgeries are highly successful. Mostly, the penis looks normal after the surgery, and boys will have normal urination and reproduction.