Hypospadias occurs when the urethral opening is below the tip of the bulbous end of the penis (glans). The opening can be on the glans along the shaft, at the pouch that holds the testicles (scrotum) or between the scrotum and the anus (perineum). The farther the urethral opening is from the tip, the more the penis will be curved.

Causes and Risk Factors for Hypospadias

Hypospadias is present at birth (congenital) and its causes are unknown. However, contributing factors may include genetic factors, since there is a 20 perecnt chance of a child having hypospadias if a family member has it. Multiple births also appears to increase the risk for the condition.

Certain endocrinological conditions, such as low androgen levels and maternal exposure to increased levels of progesterone during in vitro fertilization can increase the risk of hypospadias.

Environmental conditions, such as exposure to estrogen from pesticides on fruits and vegetables, or drinking milk from pregnant cows can increase the risk of hypospadias.

Symptoms of Hypospadias

Symptoms of hypospadias include:

  • Downward spray of the urine stream
  • Hooded appearance of the penis
  • Undescended testicles
  • Inguinal hernias (in the groin)
  • Upper urinary tract anomalies
  • Backflow of urine from the ureter to the bladder

Diagnosing Hypospadias

Diagnosing hypospadias usually includes a physical examination or a prenatal ultrasound.

Treating Hypospadias

Surgery is the recommended treatment for hypospadias. The goal of surgery for hypospadias is to reposition the urethral opening and straighten the shaft of penis. Surgery is performed ideally between three and 18 months, although it can be done at any age, even in adulthood. If it is done on an infant, circumcision should be delayed, as the foreskin tissue might be needed.

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