Hypospadias

Treating hypospadias

Hypospadias is possibly the most common congenital or birth defect affecting the male urethra. Ordinarily, the urethra opens at the tip of the penis glans, at a point called the meatus; however, in males with hypospadias, this opening can occur anywhere along the urethral groove (the line that runs along the underside of the penis). Most cases of hypospadias are correctable, although correction may be more difficult in cases connected with chordee.

Hypospadias is not a directly inherited problem, although there are slight indicators that it may have a genetic factor. In most cases of hypospadias, no direct cause is found. Some experts have suggested a link with chemicals, or maybe even with a deficiency of prenatal testosterone.

Treatment of Hypospadias

Hypospadias will usually require surgery to the body of the penis. Assuming that the child is in good physical health, the biggest factor in the length and complication of the surgery is the position of the urethra. For example, a penoscrotal hypospadias, where the urethra is open near the scrotum, will require more complex surgery than a glanular hypospadias, where it is open near the meatus. In the latter case, there may be no cause for corrective surgery, but usually an operation carried out under general anaesthetic is performed. If the child has a urethral opening near the scrotum, surgeons may perform an operation upon that area, too, to create a normal-looking scrotal area. Other penis surgery, such as correcting a chordee or reforming the glans of the penis, may be done at the same time.

Diseases Connected to Hypospadias

Problems with hypospadias have been connected to a number of other deformities of the male genitalia. Chordee, where the head of the penis is curved downwards, sometimes because the skin of the urethra is tethered to the skin of the penis, is one such condition. Epispadias, where the penis is small and not properly closed, exposing the urethra, is another. In more extreme cases, the bladder or perineum is open, requiring immediate surgery.

These problems are all of unknown congenital origin, suggesting that there may be some more complicated link between maternal hormone balance and fetal genital development.