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Hypospadias
Related Subjects: |Hypospadias |Phimosis
⚠️ Important: Babies with hypospadias should not be circumcised - the foreskin is often required during corrective surgery. 👶
📖 About
- Hypospadias = congenital condition where the urethral meatus opens on the ventral (underside) surface of the penis rather than the tip.
- Occurs in ~1 in 400 male births.
🧪 Aetiology
- Congenital failure of urethral folds to fuse normally during embryogenesis.
- ↑ incidence in families and premature infants.
- Rarely associated with genetic syndromes or disorders of sex development (esp. proximal hypospadias).
🔎 Clinical Presentation
- Penile hooding: dorsal foreskin present, ventral deficiency.
- Chordee: abnormal ventral curvature, worse on erection.
- Urethral opening on underside (glanular, midshaft, or proximal).
- Occasional incomplete scrotal fusion.
📊 Classification
- Distal (glanular/subcoronal) – most common.
- Midshaft – less common.
- Proximal (penoscrotal/perineal) – rare, often more complex, may require endocrine/genetic evaluation.
🧪 Investigations
- Diagnosis is clinical on newborn exam.
- Further work-up (renal USS, karyotype, endocrine referral) may be considered in proximal hypospadias or if other anomalies are present.
🔧 Management
- Urology referral: All suspected cases should be referred to a paediatric urologist.
- Corrective surgery: Usually between 6 months – 2 years (before school age). Aims to:
- Straighten the penis (correct chordee).
- Reconstruct a terminal urethral opening.
- Achieve normal cosmetic appearance.
- Multiple operations may be needed for proximal/severe forms.
🌟 Teaching Pearl
- Hypospadias + undescended testes → consider DSD → urgent specialist referral.
🔗 Links
| The content on this website is provided for educational and informational purposes only to support exam preparation (e.g., MLA, MRCP, USMLE) and learning. This is NOT medical advice, diagnosis, treatment, or professional guidance. It does not replace consultation with a qualified healthcare professional, official guidelines (e.g., NICE, GMC, BNF), or supervised clinical practice. Always verify information with current, authoritative sources. Makindo and its contributors accept no liability for any reliance on this content, including errors, omissions, or any resulting harm, loss, or consequences. By using this site, you agree to these terms. |
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