Everything You Need to Know About Hypospadias

Hypospadias is one of the most common congenital defects. Its current incidence is estimated to be in the order of 1 case per 300 males in Italy.

This condition can vary in severity, but the precise cause remains unknown. Fortunately, hypospadias does not involve other defects in the urinary system or other organs, but if left untreated, it can cause significant problems in adulthood. However, with corrective surgery, normal urination, sexual activity, and reproductive capacity can be restored.

What is hypospadias?

Hypospadias is a congenital condition affecting the urethra, the tube through which urine is excreted from the body. In males born with hypospadias, the opening of the urethra, called the urethral meatus, is in an abnormal location. Rather than being located at the tip of the penis, the meatus may be in different positions, such as under the end of the penis or even around the scrotum.

Causes of Hypospadias

For most cases, the exact causes of hypospadias remain unknown. However, studies have indicated that both genetic and environmental factors may play a role in its manifestation.

• In cases where the father of the child is born with hypospadias, the chances of the second child being affected are about 12 in 100.
• If both the father and the baby's brother have hypospadias, this risk increases to about 21 in 100.

Certain environmental factors during pregnancy, such as the mother's diet, drinks or medications taken, can also increase the risk of hypospadias.

Diagnosis

Hypospadias is generally diagnosed at the time of birth during a physical examination. The doctor may note the abnormal position of the urethral meatus, as well as any irregularities in the foreskin, such as a partially formed foreskin.

Treatment

To correct hypospadias, surgery is often recommended. The surgery involves several steps, including straightening the shaft, creating a new urinary canal, and placing the meatus in a correct position, usually near the tip of the penis. Circumcision can be performed using foreskin tissue to cover the reconstructed urinary canal.

The ideal time for surgery is usually between 6 and 12 months of age, although younger children may have a less problematic recovery and a better memory of the procedure.

Recovery and Possible Complications

Most patients require a few days of recovery after surgery, during which a catheter may be placed to facilitate urination. Some may experience swelling and bruising, but this tends to subside within the first six weeks, and complete wound healing occurs within six months.

The most common complications include the formation of holes, known as fistulas, in another part of the penis, and scarring in the canal or meatus, which can affect urination. These complications can be treated, and follow-up with a urologist is important to monitor any problems and ensure that surgery has been successful.

Although hypospadias can present challenges, early diagnosis and appropriate intervention can allow patients to lead normal lives and prevent future problems.

If you have any questions or doubts, please take advantage of our Open Day dedicated to Pediatric Urology, with Prof. Giacinto Marrocco , Medical Specialist in Pediatric Clinic and Pediatric Surgery, and Dr. Maria Luisa Perrotta, Medical Specialist in Pediatric Urology Surgery.