Description

Hypospadias (hi-poe-SPAY-dee-us) is a condition that occurs because the unborn baby is called a fetus develops in the uterus. The opening of the urethra is on the underside of the penis instead of at the tip. The urethra is the tube that drains urine from the bladder to the outside of the body.

Hypospadias is common and doesn't cause difficulty in caring for your baby. Usually, the surgery can create a typical looking penis that works correctly. With success in the treatment of hypospadias, most of the men can pass into the urine properly. And with the successful treatment of hypospadias, the condition does not prevent the sperm to fertilize an egg.

Symptoms

In hypospadias, the opening of the urethra is on the underside of the penis instead of at the tip. In most cases, the opening of the urethra is inside the head of the penis. Less frequently, the opening is in the middle or at the base of the penis. Rarely, the opening is in or under the scrotum.

The symptoms of hypospadias may include:

  • Opening of the urethra in a place other than the tip of the penis.
  • Down the curve of the penis. This condition is called chordee.
  • With hood of the appearance of the penis, because only the top half of the penis is covered by the foreskin.
  • The differences in the spray when the passage of urine.

When to see a doctor

The majority of infants with hypospadias diagnosed soon after birth, while still in the hospital. But it can be more difficult to identify hypospadias if there is only a slight change in where the opening of the urethra is. Talk with your doctor or other health care professional if you have concerns about the appearance of the penis of your child or if your child has problems with the passage of the urine.

Causes

Hypospadias is a condition that is present at birth. As the penis develops in a man's unborn baby, certain hormones stimulate how the urethra and foreskin form. Hypospadias results from a change in the action of these hormones. This keeps the two sides of the urethral folds to bind completely. The location of the opening of the urethra depends on when the union were arrested.

In most cases, the exact cause of hypospadias is not known. Sometimes, the hypospadias is caused by changes in genes, but the environment can also play a role.

Risk factors

Although the cause of this anomaly is not known, these factors may be related to the condition:

  • The history of the family. This condition is more common in children with a family history of hypospadias.
  • Genetics. Some changes in genes can play a role in the change of hormones that stimulate how the male genitals develop.
  • The maternal age of more than 35. Some research suggests that there may be an increased risk of hypospadias in male infants born to women over 35 years old.
  • Exposure to certain substances during pregnancy. A link between hypospadias and a mother's exposure to certain hormones or certain compounds, such as pesticides or industrial chemicals is being looked at. But more research is needed to confirm this link.

Complications

If not corrected, can result in:

  • The differences in how the penis looks.
  • Problems to learn how to use a bathroom.
  • Unusual curve of the penis with an erection.
  • The problems of the release of sperm from the penis. This version is called ejaculation.

Diagnosis

Your child's pediatrician can diagnose hypospadias based on a physical exam. Probably refers to a surgeon that specializes in the genital and urinary conditions, call a pediatric urologist for further evaluation. Medical centers with the expertise of computers can help to see the options of treatment and can provide expert treatment.

When the opening of the urethra is not at the tip of the penis and the testicles may not be felt in the examination, the genitalia can be difficult to identify as clearly male or female. This is called atypical genitals. When this happens, an evaluation by a multidisciplinary team is recommended.

Treatment

Some forms of hypospadias are very mild and do not need surgery. But generally, the treatment involves surgery to place the opening of the urethra at the tip of the penis. If necessary, surgery to straighten the shaft of the penis can also be made. The surgery is usually performed between the ages of 6 and 12 months.

Circumcision likely it is that you cannot do if your penis looks different from the usual. In its place, the foreskin tissue may be left in place for use during surgery to create a penis that looks and works correctly. If the hypospadias is found during the circumcision, the procedure is usually finished. In any of these cases, referral to a pediatric urologist is recommended.

Surgery

For most forms of hypospadias, the treatment consists in a single surgery, which is performed on an outpatient basis. Some forms of hypospadias require more than one surgery.

When the opening of the urethra is close to the base of the penis, the surgeon may require the use of grafts of tissue of the foreskin or from the inside of the mouth to reconstruct the urine canal in the correct position.

Results of surgery

To the majority of men, the surgery is highly successful. Most of the time the penis looks typical after surgery. Most men can pass into the urine properly. And with the successful treatment of hypospadias, the condition does not prevent the sperm to fertilize an egg.

Occasionally, a hole called a fistula that develops along the bottom of the penis, where the new urinary channel was created. This results in leakage of urine. Rarely, there is a problem with the healing of the wound or scar. These complications may need another surgery to repair.

The follow-up care

Your child will need a couple of visits to the surgeon after the surgery. After that, the regular monitoring of your child's pediatric urologist is recommended after training and in puberty to check the healing and possible complications.

Preparing for your appointment

Most often, infants with hypospadias are diagnosed while still in the hospital after their birth. If your baby has hypospadias, probably refers to a pediatric urologist. Here's some information to help you prepare for your appointment.

What you can do

Before the appointment:

  • Ask a family member or friend to go with you — that person can help you remember the information and provide support.
  • Make a list of questions to ask your doctor or other health care professional.

Questions could include:

  • Does my child need to have surgery?
  • When is the best time for surgery?
  • What are the risks of this surgery?
  • What happens if my child doesn't have the surgery?
  • Will this condition affect my child's fertility or sexual function later in life?
  • What is the probability of a future for the children to have the same condition?
  • Are there brochures or other printed material I can have?
  • What websites do you suggest?

Feel free to ask questions during your appointment.

What to expect from your doctor

Be prepared to answer the questions of your baby's health care professional, such as:

  • Has someone in your family has been diagnosed with hypospadias?
  • Does your child the penis to curve down during an erection?
  • Have you noticed any unusual spraying when your child passes urine?
Symptoms and treatment of Hypospadias