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Hypospadias

Disclaimer: This fact sheet is for education purposes only. Please consult with your doctor or other health professional to make sure this information is right for your child.

What is it?

Hypospadias is an abnormality of the penis which has three features:

• The opening is not in the correct place - it is usually further back from the tip of the penis on the underside.
• There is often bending or curvature of the penis ("chordee") which is more pronounced during erection.
• The foreskin is usually missing on the lower half, giving a hooded or incomplete appearance. The foreskin can sometimes be intact.

The condition is usually identified at birth but sometimes it can be missed for several years.

How common is it?

Hypospadias is fairly common. It occurs in approximately one in 300 boys. The incidence is increasing.

What causes hypospadias?

The cause is unknown. It is usually an isolated abnormality. It is not strictly an inherited trait, like eye or hair colour, but it tends to occur more frequently in families where there is a history of hypospadias.  The risk of having another child with hypospadias is about 1:30 or 14% of male siblings (so you should not let it affect your family planning).

Are there any associated problems with hypospadias?

Most boys with hypospadias have no other problems.  However if the hypospadias is severe, there may be a need for further investigations, such as ultrasounds, x-rays or blood tests to rule out kidney or other problems.

Will my son need an operation?

Usually. The operation aims to:

• Straighten the penis, so that sexual intercourse can take place.
• Move the urethral opening to the end of the penis so that the child can stand and void.
• Improve the appearance of the penis.  The child will usually look circumcised after the repair.

Not all children require an operation.  This may be the case if the child has a good stream and a straight erection. If an operation is needed then it is generally best carried out before the child is 2 years old. Your child does not usually need to stay in hospital overnight after surgery.

Sometimes more than one operation is required to complete the repair. The need for a second operation may not arise for many years.

Can my son be circumcised before the operation?

No. The foreskin is needed for the hypospadias repair, so routine circumcision should not be performed.

• Hypospadias can be repaired.
• If you are worried, talk to your child's doctor.
• It is important not to circumcise your child if hypospadias is noted at birth.

The Children's Hospital at Westmead Tel: (02) 9845 3585 Fax: (02) 9845 3562 www.chw.edu.au	Sydney Children's Hospital, Randwick Tel: (02) 9382 1688 Fax: (02) 9382 1451 www.sch.edu.au	Kaleidoscope, Hunter Children's Health Network Tel: (02) 4921 3670 Fax: (02) 4921 3599 www.kaleidoscope.org.au