Hypospadias in Children

Hypospadias is a problem where the opening of the urethra is not at
the tip of the penis. The urethra is the tube that carries urine from the bladder
to the
outside of the body. With hypospadias, the end of the tube is lower down on the
underside of the penis. Or it may be in the scrotum. The fold of skin on top of the
penis (the foreskin) also forms abnormally. Hypospadias can prevent normal urine flow.
Later in life it can cause problems with semen flow. This can lead to not being able
to
have children (infertility).

Hypospadias is a problem that some boys are born with (congenital).
It happens during growth in the mother’s uterus. As the baby grows in the uterus,
the
tissue on the underside of the penis that forms part of the urethra doesn’t fully
close.
The foreskin doesn’t fully develop. This leaves extra foreskin on the top side of
the
penis. And no foreskin on the underside of the penis.

A baby is more at risk for
hypospadias if he:

  • Has an older mother
  • Has a father with other conditions of the urinary tract or genitals
  • Is born early (preterm birth)
  • Has a low birth weight
  • Is a twin
  • Has a mother who has diabetes during pregnancy (gestational diabetes)
  • Was exposed before birth to secondhand cigarette smoke and pesticides

Symptoms can occur a bit differently in each child. They can include:

  • Abnormal look of foreskin and penis
  • Abnormal direction of urine stream
  • End of penis curves downward

The symptoms of hypospadias can
seem like other health conditions. Have your child see their healthcare provider for
a
diagnosis.

The healthcare provider will ask about your child’s symptoms and
health history. They may also ask about your family’s health history. The provider
will
give your child a physical exam. This will include looking at your child’s penis and
foreskin.

Treatment will depend on your child’s symptoms, age, and general health. It will also
depend on how severe the condition is.

Hypospadias can be fixed with surgery. Surgery is often done when a baby is 6 to 24
months old. This is when penile growth is minimal. Your baby should not be circumcised
at birth. This is because the foreskin may be needed to repair the penis. In some
cases, more than one surgery is needed to complete the repair.

Talk with your child’s healthcare
providers about the risks, benefits, and possible side effects of surgery.

If a hypospadias is not repaired, your child may have problems such as:

  • Abnormal urine stream. The urine stream may point in the
    direction of the opening, such as downward. Or it may spray in many directions.
  • Curving penis. As your child grows, his penis may curve.
    This can cause sexual problems later in life.
  • Infertility. If the urethral opening is closer to the
    scrotum or perineum, your child may have problems with fertility later in life.

Call the healthcare provider if your child has:

  • Symptoms that don’t get better, or get worse
  • New symptoms
  • Hypospadias is a problem where the
    opening of the urethra is not at the tip of the penis. The opening may be lower down
    on the underside of the penis. Or it may be in the scrotum. The foreskin of the penis
    also forms abnormally.
  • It is a problem that some boys are born with. It happens during a baby’s growth in
    the uterus.
  • It can be fixed with surgery. Surgery is often done when a baby is 6 to 24 months
    old.
  • Your baby should not be circumcised at birth. This is because the foreskin may be
    needed to repair the penis. In some cases, more than one surgery is needed to complete
    the repair.
  • If the condition is not repaired, your child may have problems such as abnormal urine
    flow, a curving penis, and infertility.

Tips to help you get the most from a visit to your child’s healthcare provider:

  • Know the reason for the visit and what you want to happen.
  • Before your visit, write down questions you want answered.
  • At the visit, write down the name of a
    new diagnosis and any new medicines, treatments, or tests. Also write down any new
    instructions your provider gives you for your child.
  • Know why a new medicine or treatment is prescribed and how it will help your child.
    Also know what the side effects are.
  • Ask if your child’s condition can be treated in other ways.
  • Know why a test or procedure is recommended and what the results could mean.
  • Know what to expect if your child does not take the medicine or have the test or procedure.
  • If your child has a follow-up appointment, write down the date, time, and purpose
    for that visit.
  • Know how you can contact your child’s
    provider after office hours. This is important if your child becomes ill and you have
    questions or need advice.