If your baby boy was born with a penis that doesn’t look or work quite like it’s supposed to, you want to know if they can be treated right away. And that’s understandable. Urine and sperm travel through the urethra, the tube that opens at the tip of the penis. But boys with hypospadias are born with the location of the opening ranging anywhere within the head or shaft of penis, the scrotum, or perineum
Hypospadias is pretty common and can sometimes be left as is. But doctors can do surgery to fix the problem when needed.
Depending on where the opening is on your son’s penis, they might have problems having children because their sperm might not be able to effectively fertilize an egg.
Keeping it clean may be hard, too. The opening can be bigger than normal. And when it’s located on the underside of the penis, it can be difficult to check on whether it’s clean, or if there is redness or infection.
If their hypospadias isn’t corrected early, a boy may have to sit down when they pee. And if they still have it as an adult, they could have problems having children because it could be hard to direct their sperm inside a woman.
What Causes It?
As with many other birth defects, doctors aren’t sure why some boys get hypospadias. They think some of the reasons could be:
- Genetics. It’s more likely if the boy has a father or brother who were born with it. It is also associated with some genetic syndromes.
- Fertility treatments. The mother may have used hormone therapy or medicine to help them get pregnant..
- The mother’s age and weight. There’s more chance a baby will be born with hypospadia if their mom is overweight and over age 35, has diabetes prior to their pregnancy
- Exposure to smoking or pesticides
You can reduce your baby’s chances of hypospadias while you’re pregnant.
- Don’t smoke or drink alcohol.
- Keep a healthy weight.
- Take 400 to 800 micrograms (mcg) of folic acid per day (the bottle should have the dosage printed on it – 400 mcg, for example.)
- Visit your doctor.
How Do I Know if My Son Has It?
Doctors can identify hypospadias by examining your baby’s penis during the routine exam after birth. Most often it’s easy to see that the opening is in the wrong place. The doctor will suggest delaying circumcision and refer you to a urologist.
In some cases, the penis also curves in a downward arc, something doctors call chordee. It shows during an erection.
Types of Hypospadias
There are three kinds, depending on where the urethra opening is located:
- Near the head of the penis (subcoronal)
- Along the shaft of the penis (midshaft)
- Where the penis and scrotum meet, or on the scrotum (penoscrotal)
How Does the Surgery Work?
If the location of the opening is near the tip, the penis often works well enough to leave it alone.
But many cases of hypospadias call for surgery to move the urethra and opening. This procedure often includes straightening the penis. The goal of surgical correction is to create a penis with normal function and appearance with a urethral opening as close as possible to the ventral tip of the penis. Surgical correction should result in a properly directed urinary stream and a straightened penis upon erection.
Doctors use skin from the foreskin or elsewhere on the body to repair the opening. Your doctor likely will not circumcise your son, but leave the foreskin intact for this purpose.
Children who get this surgery are usually between 3 months and 18 months old. The child is anesthetized -- not awake -- during the surgery. Usually they can go home the same day.
If doctors missed your son’s hypospadias, it still can be treated later. It’s usually obvious because of the direction their pee comes out.
Surgery to fix this condition is highly successful. It also works on adults who have the problem, but it is more difficult, and not as common.