Hypospadias is one of the most common congenital conditions affecting the male genitalia, occurring in approximately 1 out of every 200 to 300 live male births. It is a condition where the urethral opening the hole through which urine and semen exit the body is located on the underside of the penis rather than at the tip. In some cases, it may be only slightly displaced, while in others, the opening may be located near the base of the shaft or even in the scrotum.
While mild cases may seem merely cosmetic, untreated hypospadias can have significant functional consequences, especially related to urination and sexual function. In more severe forms, fertility may also be affected, making early diagnosis and timely treatment essential for long-term quality of life.
What Are Hypospadias?
In a typical male anatomy, the urethral opening is located at the tip of the penis, allowing for a straight urine stream and proper semen delivery during ejaculation. In hypospadias, this opening can be found anywhere along the underside of the penis, and it is often accompanied by:
- Chordee, or downward curvature of the penis
- Abnormal foreskin development, often forming a “hooded” appearance
- Spraying or deflected urine stream
The severity of hypospadias depends on the location of the urethral meatus (opening). The further it is from the tip, the more likely it is to cause functional difficulties.
Why Treatment Is Important
Though some families may initially consider postponing or avoiding surgical treatment, leaving hypospadias uncorrected can lead to several complications as the child grows, particularly in adulthood. Among the most significant concerns is reproductive health.
During sexual intercourse, proper positioning of the urethral opening is essential for delivering sperm into the vaginal canal. If the opening is significantly displaced, ejaculation may not occur effectively within the vaginal vault, reducing the chances of fertilization. This can lead to subfertility or infertility, even if the individual has normal sperm production.
In addition to reproductive issues, untreated hypospadias may cause:
- Difficulty controlling the urine stream, often requiring the child or adult to sit while urinating
- Psychosocial distress, due to the appearance of the genitalia or challenges with urination and sexual function
- Pain or discomfort during erection or sexual activity, especially when chordee is present
These challenges often lead to reduced self-confidence, sexual anxiety, or emotional stress factors that can impact relationships and overall well-being.
When and How Is Hypospadias Treated?
Hypospadias is typically corrected through surgical intervention, ideally performed between 6 to 18 months of age. At this stage, children tolerate anesthesia well, healing is faster, and the psychological impact is minimal. However, surgery can also be performed later in life if the diagnosis is delayed or if earlier procedures were unsuccessful.
The goal of surgery is to:
- Reposition the urethral opening at the tip of the penis
- Correct any penile curvature (chordee)
- Restore normal appearance and function
Modern surgical techniques offer excellent cosmetic and functional outcomes, especially when performed by experienced pediatric urologists. Postoperative recovery is generally smooth, and most patients regain full urinary and sexual function.
Long-Term Outlook
With proper surgical correction, most children with hypospadias grow up with normal urinary and sexual function, including the ability to father children. However, delaying or avoiding treatment increases the risk of long-term complications, particularly related to reproductive health.
In some complex cases or when surgery is performed in adulthood, additional procedures may be required. That’s why early diagnosis, careful evaluation, and timely intervention are the key to minimizing future health risks.
At Erdem Hospital, with over 37 years of surgical and urological expertise, we offer comprehensive care for children and adults with hypospadias. Our multidisciplinary team ensures that each patient receives personalized treatment, emotional support, and long-term follow-up for optimal outcomes.
Frequently Asked Questions (FAQ)
What causes hypospadias?
Hypospadias occurs during fetal development when the urethra does not fully extend to the tip of the penis. The exact cause is not always known, but genetics, hormones, and environmental factors may contribute.
Is hypospadias painful?
In infancy, hypospadias is not typically painful. However, untreated cases may lead to discomfort during erections or intercourse later in life.
Can a person with hypospadias have children?
Yes especially if the condition is treated surgically. However, untreated moderate to severe hypospadias may make ejaculation into the vagina difficult, affecting fertility.
Is surgery always necessary?
Most moderate to severe cases require surgery for functional and cosmetic reasons. Very mild cases may not need surgery but should be evaluated by a specialist.
Can adults be treated for hypospadias?
Yes. Although pediatric surgery is ideal, adults with untreated or failed repairs can still benefit from reconstructive surgery performed by an experienced urologist.