What is Hypospadias? Symptoms, Causes, Diagnosis & Treatment

Most males are born with a normal-looking and functional penis. However, some males are born with hypospadias, a frequent congenital disability. Hypospadias results in a penis that is not only dysfunctional but also abnormal in appearance. Numerous surgical methods by pediatric urologists are there to address this issue.

About Hypospadias

Hypospadias meaning is a birth abnormality (congenital disorder) wherein the entrance of the urethra is located on the bottom of the penis rather than at its tip.

In most situations, the condition seems to be the only developmental issue in newborns, and it does not indicate any urinary system or organ defects.

The condition is prevalent and does not complicate the care of your child. Further surgery often returns your child’s penis to its original form. With effective treatment, the majority of males can urinate and reproduce normally.

What Is The Normal Functioning Of Penis?

The primary functions of the penis are to transport urine and sperm from the body. The urethra refers to the tube that transports urine and sperm from the penis to the body’s exterior, and the outside entrance is the meatus. So when meatus is at the penis’s head tip (“glans”), both activities are simpler.

Symptoms

In hypospadias the urethral opening is on the penis bottom rather than at the tip in normal conditions or at the top of Penis like in epispadias. The entrance of the urethra is usually found inside the penis head. Moreover, the entrance occurs less often at the center or at the base of the penis, and the entrance is rarely in or under the scrotum.

The condition may cause the following signs and symptoms:

• A urethral opening at a position excluding the penis tip.
• Descending curvature of the penis (chordee)
• The penis has a hooded look since the foreskin conceals only the upper half
• Abnormal spilling during urination

Hypospadias Causes

The condition is congenital, implying it is present from birth. Certain hormones drive the development of the foreskin and urethra in male babies as the penises grow. So this condition occurs when the activity of these hormones malfunctions, leading the urethra to grow abnormally.

The specific explanation behind the cause of this condition in most instances is still unknown. Occasionally, hypospadias is caused by genetics if father has it then there is a chance that you child also have it. In fact 7 in 100 children have founded with these birth defect in this conditions, but the surroundings could also contribute.

Can A Baby With Hypospadias Be Circumcised?

Any baby with this condition should not undergo circumcision.

The surgeon may utilize the additional skin from the uncircumcised foreskin for the restoration.

Can Hypospadias Cause Infertility?

Hypospadias may hinder the normal flow of urine. Further, it may create difficulties with sperm flow later in life. However, this may result in the inability to bear children (infertility).

At What Age Is Hypospadias Repaired?

The most common age for hypospadias correction in males is between 6 months and two years. Further, the procedure is performed as an outpatient.

Hypospadias Types

The hypospadias type identification depends on the location of the urethral orifice:

• Subcoronal: Near the penis’s head.
• Midshaft: Along the penile shaft’s
• Penoscrotal: The region where the scrotum and penis meet

Risk Factors

Although the hypospadias causes aren’t clear, the following factors may lead to the condition:

• Family history: This condition could be more prevalent in newborns with a history of hypospadias.
• Genetics: Certain gene variants may contribute to the interruption of hormones that encourage male genital development.
• Maternal age exceeding 35: Some evidence shows those baby boys delivered to mothers elder than 35 may have a higher likelihood of the condition.
• Pregnancy-related exposure to certain drugs: Assumptions suggest a link between hypospadias and a mother’s contact with specific hormones or molecules, like insecticides or industrial toxins. But further research is required to establish this.

Complications Due To The Condition

When not addressed at the right time, the condition may lead to:

• Abnormal penis appearance
• Difficulties learning about using a toilet
• Abnormal penis curvature during erection or peyronies disease
• Retrograde Ejaculation or problem with ejaculation

Diagnosis

The physician may identify hypospadias followed by a physical examination of your child. Furthermore, they will likely send you to a pediatric urologist specializing in urinary and genital issues for additional assessment. Further medical facilities with specialization teams may assist in evaluating treatment alternatives and offer professional care.

When the urethral opening is anomalous, and the doctor can’t feel the testicles, it might be challenging to determine whether the genitalia belongs to a boy or girl (ambiguous genitalia). In this situation, a multidisciplinary team assessment is necessary.

Hypospadias Treatment

Some kinds of hypospadias are quite mild and may not need surgical intervention. However, surgery is often necessary to realign the urethral aperture and, if essential, to realign the penile shaft.

If the penis has an aberrant appearance, the doctor avoids circumcision. During circumcision, if hypospadias is discovered, the surgery should be performed. The doctor may refer to a pediatric urologist.

Surgery

In the majority of cases may, treatment is possible via a single outpatient procedure. Certain types will need more than one surgical procedure to fix the problem.

In case the position of the urethral opening is close to the penis base, the surgeon might have to utilize tissue grafting from the foreskin, or the mouth’s inside to rebuild the urine channel in the right location, therefore treating the condition.

Complications Following Hypospadias Surgery

In the majority of situations, surgical procedures are quite effective.

Usually, the penis seems normal following surgery, and urination and reproduction get to normal.

Sometimes a fistula forms along the penis’s bottom, wherein the doctor creates a new urinary channel, resulting in urine leaking. Infrequently, there are complications with the healing process or scarring. So these problems may need extra surgical intervention.

The majority of problems evolve during the first few months following surgery; however, fistulas or obstructions go undetected until several years. After the tissues have recovered after a previous procedure, most defects may be corrected surgically (at least six months).

It isn’t easy to consider further surgery in these unique circumstances. However, some choices provide anticipation for success. Scar tissue from previous surgeries may be removed and replaced with normal tissues from other body sections. So this may offer a functional urinary channel that seems normal.

Care After Surgery

Following surgery, the baby will require multiple visits to the doctor.

Following toilet training and puberty, frequent follow-up with the child’s pediatric urologist is necessary to monitor healing and any issues.

Is Surgery Necessary?

Many parents inquire whether mild cases of hypospadias necessitate surgery, and it is difficult to foretell a child’s challenges later in life. However, there are several grounds to propose rectification, regardless of the severity of the illness.

• 15 out of every 100 boys with the condition will have a downwardly curved penis. When the child is an adult, a significant curvature might hinder his ability to get an erection.
• Although the meatus could be at a practically typical location, it is often misshapen. Some holes are more substantial than others. Many possess a skin web beyond the entrance. So these anomalies may affect the urine flow. Further, some boys may see pee streaming sideways or downward. Many individuals must sit to urinate. The process of voiding might cause pain and irritation to adjacent tissues. The penis is functional, but these issues are unpleasant.
• The unfixed, partially developed foreskin will seem odd, which may draw attention to the issue. According to studies, males with untreated hypospadias have poorer self-esteem.

Today, most pediatric urologists recommend surgical correction for all but the most minimal cases of hypospadias. In most instances, the advantages of surgery much exceed their risks.

Final Say

Hypospadias is a congenital disorder that causes the urethral opening to be placed anywhere besides the penis’ tip.

The condition, if not addressed, might lead to issues with urine and sexual function. However, treatment for the condition is quite successful. During surgery, the penis is straightened, and the hole is placed in the correct area. Moreover, hypospadias healing often lasts a lifetime.

If any men face challenges with any condition relating to their sexual health or any other sexual dysfunction, then the Ohman experts are available to assist men via online consultation. Further, Ohman’s online store offers FDA-approved medication that will help patients treat their sexual conditions.

Reference – CDC