Introduction
Hypospadias is a congenital abnormality of the penis which occurs in approximately 3/1,000 male infants. There appears to be a significant genetic element, with further male children having a risk of around 5-15%.
Aetiology
Hypospadias most commonly occurs as an isolated disorder. However, associated conditions include cryptorchidism (present in 10%) and inguinal hernia.
Pathophysiology
Hypospadias is characterised by
- a ventral urethral meatus
- a hooded prepuce
- chordee (ventral curvature of the penis) in more severe forms
- the urethral meatus may open more proximally in the more severe variants. However, 75% of the openings are distally located.
Clinical features
It is usually identified on the newborn baby check. If missed, parents may notice an abnormal urine stream.
Management
Management
- once hypospadias has been identified, infants should be referred to specialist services
- corrective surgery is typically performed when the child is around 1-years-old
- it is essential that the child is not circumcised prior to the surgery as the foreskin may be used in the corrective procedure
- in boys with very distal disease, no treatment may be needed.