Hypospadias

Overview

Hypospadias is a congenital condition in which the urethral opening is located on the underside of the penis rather than at the tip. It is one of the most common congenital anomalies in males, affecting approximately 1 in every 200 to 300 male births, and can vary in severity. In some cases, the urethral opening may be just below the tip of the penis, while in more severe cases, it may be located at the base of the penis or within the scrotum.

Historically, hypospadias has been recognized for centuries, with descriptions dating back to ancient Greek and Roman medical texts. The term ‘hypospadias’ originates from the Greek words ‘hypo’ meaning under and ‘spadon’ meaning a rent or fissure. It was noted by early physicians as a developmental anomaly. Surgical interventions aiming to correct hypospadias have evolved significantly since the 19th century, with modern urology achieving high success rates in reconstructive surgeries.

Causes

Hypospadias occurs when the urethra and penis does not develop properly during fetal growth. The exact cause is unknown, but it is believed to involve a combination of genetic and environmental factors. Hormonal factors during pregnancy may also play a role.

Risk Factors

• Family history of hypospadias.
• Maternal age over 35 years.
• Exposure to certain environmental factors during pregnancy, such as endocrine disruptors.
• Use of fertility treatments or certain medications during pregnancy.

Complications

In many cases, hypospadias is accompanied by other penile abnormalities, such as chordee (a downward curvature of the penis), hooded foreskin (where the foreskin appears incomplete), and urethral plate abnormalities. These can lead to difficulties with urination, sexual function, and may affect fertility if left untreated. Depending on the location, early surgical intervention is often recommended to correct the anatomical positioning and function of the urethra, usually before the child reaches 12 months of age.

Difficulty with urination due to abnormal urethral opening.

Increased risk of urinary tract infections.

Issues with sexual function and fertility if left untreated.

Psychological and social impact due to the appearance of the penis.

Prevention

There are no specific preventive measures for hypospadias. However, avoiding exposure to potential environmental risks and maintaining a healthy pregnancy may help reduce the risk.