Hypospadias – It’s A Boy Thing


There’s more to your newborn baby boy than 10 fingers and 10 toes. Soon after he is born, your health care provider will check for any congenital anomalies. If you have a baby boy one of these could be hypospadias.

There’s an estimated one in 300 males born with hypospadias. This is a birth defect in which the opening for the urethra (the tube for urine) is not in the usual location on the head of the penis, but on the underside. In some instances, the penis is also curved downwards – this is known as chordee. Both conditions require corrective surgery in order to prevent problems with urination and sexual intercourse later in life.

Hypospadias can vary from minor to severe and depends on whether the urethra is near the head of the penis, along the shaft of the penis or where the penis and scrotum meet.

A baby’s genitals begin to develop during the eighth week of pregnancy. Before this, the urethral openings from the bladder are in the same place for boys and girls. When the penis grows, the urethra grows towards the tip. By 17 weeks, the foreskin has grown over the tip, and the urethra is fully developed. When boys have hypospadias this process is, for unknown reasons, interrupted.

In babies, if the penis looks different, parents should leave the nappy off so they can watch what happens when their baby urinates. If there are no problems, the stream of urine will be forceful and project upwards in an arc that is 16-20cm high. In cases of hypospadias, this doesn’t happen, and on closer inspection, parents will see that the opening is in the wrong place.

Hypospadias can be hereditary, but it isn’t a conclusive genetic condition. It’s rare for more than one male in a family to have the condition. Men with hypospadias, whether they have had corrective surgery or not, should tell their partner for the sake of their baby.

When hypospadias is mild, some men may not even be aware of it. Many men grow up with this condition and won’t experience any pain or complications, and learn to adapt.
However, correcting hypospadias is necessary, even when it’s minor. Men like to stand when they urinate, and boys who have to sit on the toilet due to the condition are likely to be teased when they grow older and mix with other boys. Severe chordee can interfere with erections, which can
inhibit sexual satisfaction in adults.

Other complications associated with hypospadias are undescended testes,a dorsal preputial hood and a webbed penis (also known as penoscrotal fusion).

Corrective surgery of the penis is highly specialised, and that babies with urological conditions should be treated by a paediatric urologist. Specialists say that “about 50% of operations done at The Urology Hospital are corrective surgeries of previously unsuccessful procedures performed elsewhere”. They also warn that it is imperative that a circumcision is never performed if hypospadias is diagnosed, since the foreskin is used in the repair. This highlights the importance of early paediatric checks.

Urological Specialists recommend corrective surgery between six and 12 months of age, as this is a safer time for babies to have anaesthetic. Babies also heal quickly, and your little one will have no recollection of the surgery.

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