Hypospadias is a birth defect found in boys in which the urinary tract opening (meatus) is not positioned at the tip of the penis. Hypospadias can also be associated with an abnormal bend of the penis. This is often most noticeable with erection. This is called chordee.
Hypospadias occurs in about 1 out of every 300 male births and there is a slightly higher risk of hypospadias if the baby’s father or brother have a history of the same condition.
There are different degrees of hypospadias depending on the location of the meatus. The further the meatus is from the tip of the penis, the more severe the degree of hypospadias. It is always necessary to determine if there is an associated chordee.
Surgical correction of hypospadias involves extending the urinary channel (urethra) to the end of the penis. This is a relatively simple procedure when the urethral opening is just slightly out of position. In most cases, hypospadias repair can generally be treated on an outpatient basis with one surgical procedure. For more severe degrees of hypospadias, a series of procedures may be necessary in order to extend the urethral opening to the correct position. In this case, hypospadias repair is best performed in several stages. Correction of a chordee will also be done at this time if needed.
Reasons for Hypospadias and Chordee Repair
Children with hypospadias may be unable to stand and urinate with a direct stream because of the abnormal positioning of their urethral opening. Instead, they must sit on the toilet to urinate. This puts them at a significant social disadvantage because it makes them different from their peers.
A straight penis is also necessary for normal adult sexual function. Although this may not seem to be an immediate concern in childhood, it is crucial later in life for reproduction purposes. Early childhood, generally between 9 months and 24 months, is the best time for surgical repair of hypospadias and chordee correction if necessary.