An abnormality in which the opening of the urethra is on the underside of the penis rather than at the tip

  • Present at birth
  • Sometimes runs in families
  • Lifestyle is not a significant factor

Hypospadias is a common birth defect in which the opening of the urethra (the passage that carries urine from the bladder to outside the body) develops on the underside of the shaft of the penis instead of at the tip. Most commonly, the opening develops near the end of the penis, but in severe cases it can occur far back towards the scrotum. Sometimes, part of the foreskin may be missing and the penis curves downwards, a condition known as chordee. Hypospadias occurs in about 1 in 300 boys and can run in families, which suggests that a genetic factor is involved. If the condition is not treated early, an affected child may need to sit on the toilet to pass urine, unlike other boys, which may make him self-conscious.

What might be done?

Hypospadias is usually detected at birth and treated with surgery before the age of 2. During the operation, the foreskin is used to form an extension to the existing urethra so that it reaches the tip of the penis. It is therefore important that the boy is not circumcised. If chordee is also present, this can be corrected during the same operation. Surgery usually allows the child to pass urine normally. Sexual activity and fertility in later life are usually unaffected.

From the 2010 revision of the Complete Home Medical Guide © Dorling Kindersley Limited.

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