The normal male urethral opening is at the tip or end of the penis.
Hypospadias is a congenital anomaly in which the urethral opening is at the base of the penis, or along the inferior aspect of the shaft of the penis. Hypospadias is usually associated with an abnormal curvature of the penis, called "chordee". Hypospadias is one of the most common birth defects seen in infant boys. Surgery is necessary to allow normal urination, to correct the penis deformity, and to ensure normal sexual functioning. The repair is performed before the child reaches school age.
Surgical repair of hypospadias is done while the child is deep asleep and pain-free (using general anesthesia). The goals of the surgery are to repair the abnormal curvature of the penis, and to create a new urethra at the tip of the penis. A small piece of foreskin can be used to create a tube to extend the urethral length to allow placement of the urethral opening at the tip of the penis. Circumcision should NOT be performed at birth so that the foreskin can be used for the repair.
The type of repair depends on the severity of the defect. Mild defects may be repaired in a single procedure, while severe defects may require two or more procedures. Hypospadias repair is usually performed before the age of three years.
Neil K. Kaneshiro, MD, MHA, Clinical Assistant Professor of Pediatrics, University of Washington School of Medicine. Louis S. Liou, MD, PhD, Chief of Urology, Cambridge Health Alliance, Visiting Assistant Professor of Surgery, Harvard Medical School. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Ebix, Inc.
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