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%.


Hypospadias most commonly occurs as an isolated disorder. However, associated conditions include cryptorchidism (present in 10%) and inguinal hernia.


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.


  • 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.