Hypospadias Causes & Symptoms

Hypospadias is a birth defect in which the opening of the tube that carries urine is not properly placed at the end of the penis. Most cases of hypospadias are very mild and can easily be repaired with an outpatient surgery.

Hypospadias is caused by incomplete development of the urethra in the womb between eight and 20 weeks of gestation. Hypospadias are usually identified at the time of your baby’s circumcision; some pediatricians will stop the circumcision if they suspect an underlying hypospadias.

Various degrees of hypospadias result in an opening located anywhere along the length of the urethra. Degrees of hypospadias are classified according to location which can be as severe as the scrotum, but usually along the mid to distal shaft of the penis.

Hypospadias may also cause a curvature of the penis (chordee). Chordee is sometimes evident only with an erection. Without surgical correction, severe hypospadias may result in the inability to urinate standing and difficulty obtaining future pregnancy.

Incidence and Prevalence

Hypospadias occurs in approximately 1 in 300 males. Hypospadias is one of the most common birth defects of the male genitalia.

The worldwide incidence of hypospadias is rising, partially due to an increase in the number of minor cases being reported. Mild hypospadias most often occurs as an isolated birth defect without associated abnormalities.

Risk Factors and Causes

Most incidents of hypospadias occur without clear explanation. Possible causes include genetic, endocrine, and environmental factors. Genetic factors are suggested by an increase in the condition with other family members.

Endocrine (hormonal) factors occur secondary to maternal exposure to hormones during pregnancy. Environmental exposure to estrogen during urethral development may also be a risk factor. Exposure can result when the mother ingests pesticides on fruits and vegetables and milk from pregnant cows.

Signs and Symptoms

Hypospadias results in a urethral opening located below the tip of the penis. This opening is most likely located on the glans (helmet), along the shaft of the penis, or sometimes in the scrotum or behind.

The farther the opening from the tip of the glans, the more likely curvature in the penis (chordee) is present. Boys can also have a prominent dorsal hood of skin above the glans. The dorsal hood of skin can sometimes be the only initial visible abnormality. The dorsal hood can also imply underlying curvature of the penis.

Hypospadias results in a downward spray of the urine stream. It is important to try to watch your baby urinate and determine if he has a deflected stream.