Overview

Hypospadias is a congenital condition in males where the opening of the urethra, the tube that carries urine from the bladder to the outside of the body, is located on the underside of the penis instead of at the tip. In typical anatomy, the urethral opening is at the tip of the penis. Hypospadias can vary in severity, with the opening occurring anywhere along the underside of the penis, from near the tip to the base. Surgical correction is often needed to reposition the urethral opening to the tip of the penis for normal urination and appearance.

[caption id="attachment_22650" align="alignnone" width="638"] Types of Hypospadias[/caption]

Symptoms of Hypospadias

The primary symptom of hypospadias is the abnormal placement of the urethral opening. Other associated symptoms may include

- Abnormal curvature (bending) of the penis: In some cases, the penis may bend downward during an erection, a condition known as chordee.
- Undescended Testicle: There may be an increased risk of having an undescended testicle (cryptorchidism) on the affected side.
- Difficulty with urination: Depending on the severity of the condition, urination may be affected. The stream may be weaker or spray in different directions.
- Foreskin abnormalities: The foreskin may not fully cover the head of the penis, creating an appearance known as "hooded."

Causes of Hypospadias

The exact cause of hypospadias is not always clear. It is thought to be a combination of genetic and environmental factors. Some potential contributors include

- Genetics: There may be a genetic predisposition, as hypospadias can run in families.
- Hormonal factors: Changes in hormone levels during foetal development may influence the formation of the urethra.
- Environmental factors: Exposure to certain chemicals or medications during pregnancy may increase the risk.
- Maternal Factors: Certain maternal factors during pregnancy may increase the risk of hypospadias, such as maternal smoking, alcohol use, and certain medications.
- Premature Birth: Some studies have suggested a higher incidence of hypospadias in premature infants, possibly due to incomplete development of the genitalia.

Diagnosis of Hypospadias

- Physical Examination- The diagnosis of hypospadias predominantly happens shortly after a male child's birth, commonly during initial medical evaluations. Doctors identify the condition by inspecting the location of the urethral opening, which, in cases of hypospadias, isn't at the tip of the penis but rather along its underside.
- Additional Assessments- Additional assessments, such as observing the urine stream or penile curvature, might also be carried out. The primary focus then shifts to treatment planning, which almost invariably involves surgical correction. Timely identification is crucial for optimised treatment outcomes.
- Additional Evaluations- In some cases, additional tests may be conducted to assess the overall health of the urinary tract. These tests can include ultrasound, cystoscopy, or other imaging studies.
- Genetic Evaluation- Given the potential genetic factors associated with hypospadias, a genetic evaluation may be recommended to assess family history and identify any underlying genetic causes.

Treatment Options For Hypospadias

Treatment typically involves surgical correction, usually performed between 6 and 18 months of age. The specific surgical approach depends on the location and severity of the condition.

- Primary repair: In most cases, a single surgery is performed to reposition the urethral opening and correct any associated curvature. Tissue may be taken from the foreskin or other sources to reconstruct the urethra.
- Staged repair: In more complex cases, especially when the hypospadias is severe or associated with chordee, the repair may be done in stages. This involves a series of surgeries to correct the condition gradually.
- Chordee Correction: If there is associated curvature of the penis (chordee), the surgeon may also perform a correction to straighten the penis during the same surgical procedure.
- Foreskin Reconstruction: If the foreskin is involved in the surgical repair, it may need to be reconstructed to provide proper coverage for the glans.
- Post-operative care: After surgery, the child may require a catheter for a short period to allow for healing. Regular follow-up appointments are essential to monitor progress and address any potential complications.

When to Consult a Doctor

You can also get in touch with the expert Urology doctors at Narayana Healthcare based in your city to get immediate attention and medical support during injuries, health disorders or any other health concern.

Conclusion

Hypospadias emerges as a congenital condition requiring precise medical intervention for optimal quality of life. Its identification, usually shortly after birth, allows for timely surgical procedures to drastically enhance urinary and future sexual function. While not exceedingly rare, the condition can have long-lasting implications if not properly managed. With advances in medical techniques, treatment outcomes are increasingly promising. It remains crucial for parents and healthcare providers to work in tandem to ensure prompt diagnosis and effective treatment. Understanding the symptoms, diagnosis processes, and available treatments equips one to deal successfully with hypospadias, thus greatly enhancing the affected individual's long-term well-being.

- https://www.mayoclinic.org/diseases-conditions/hypospadias/symptoms-causes/syc-20355148
- https://www.urologyhealth.org/urology-a-z/h/hypospadias
- https://my.clevelandclinic.org/health/diseases/15060-hypospadias