Hypospadias is a condition in which the urethra does not develop the right way and the urethral opening meatus or pee-hole is not in the normal place at the tip of the penis. The opening can occur anywhere below the tip of the penis, along the shaft of the penis, or all the way to the scrotum. Hypospadias is one of the most common problems that boys are born with. It happens in one of to male births. There is no one cause for hypospadias.
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Hypospadias is a problem where the opening of the urethra is not at the tip of the penis.
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Take advantage by building your shopping cart now! Although prostate cancer treatment can be lifesaving, it can also take a toll on the body. This can result in a disruption to normal urinary, bowel and sexual function. Whether you have surgery, radiation or hormone therapy, you are likely to have side effects. You can get on track for good urologic health with better eating habits and small changes to your lifestyle.
Read our Living Healthy section to find healthy recipes and fitness tips to manage and prevent urologic conditions. At the Urology Care Foundation, we support research aimed at helping the millions of men, women and children who struggle with urologic cancer and disease. Most boys are born with a penis that looks normal and works well. But some boys are born with a common condition called hypospadias. Hypospadias forms a penis that not only doesn't work well but also doesn't look normal.
Pediatric urologists have come up with many surgical techniques to fix this problem. The following information should help you speak to your son's urologist. The main roles of the penis are to carry urine and sperm out of the body. The urethra is the tube that carries urine and sperm through the penis to the outside.
The opening to the outside is called the "meatus. Hypospadias is a condition where the meatus isn't at the tip of the penis. Instead, the hole may be any place along the underside of the penis. The meatus hole is most often found near the end of the penis "distal" position. But it may also be found from the middle of the penile shaft to the base of the penis, or even within the scrotum "proximal" positions.
Hypospadias is a common birth defect found in up to 1 in every boys. In most cases, hypospadias is the only developmental problem in these infants and doesn't imply there are other flaws in the urinary system or other organs. The key steps in forming the penis take place between weeks 9 and 12 of pregnancy.
During this time, male hormones tell the body to form the urethra and foreskin. Hypospadias may be caused by problems with hormones.
Hypospadias is most often noticed at birth. Not only is the meatus in the wrong place, but the foreskin is often not completely formed on its underside.
This results in a "dorsal hood" that leaves the tip of the penis exposed. It's often the way the foreskin looks that calls attention to the problem. Still, some newborns have an abnormal foreskin with the meatus in the normal place. And in others a complete foreskin may hide an abnormal meatus.
About 8 in of boys with hypospadias also have a testicle that hasn't fully dropped into the scrotum. Hypospadias is fixed with surgery. Surgeons have been correcting hypospadias since the late s. More than types of operations have been described. But since the modern era of hypospadias reconstruction began in the s, only a handful of techniques have been used by pediatric urologists. The goal of any type of hypospadias surgery is to make a normal, straight penis with a urinary channel that ends at or near the tip.
The operation mostly involves 4 steps:. Hypospadias repair is often done in a minute for distal to 3-hour for proximal same-day surgery. In some cases the repair is done in stages. These are often proximal cases with severe chordee. The pediatric urologist often wants to straighten the penis before making the urinary channel. Surgeons prefer to do hypospadias surgery in full-term and otherwise healthy boys between the ages of 6 and 12 months.
But hypospadias can be fixed in children of any age and even in adults. If the penis is small, your health care provider may suggest testosterone male hormone treatment before surgery. A successful repair should last a lifetime. It will also be able to adjust as the penis grows at puberty.
Modern hypospadias surgery results in a penis that works well and looks normal or nearly normal. Many surgeons leave a small tube "catheter" in the penis for a few days after surgery to keep urine from touching the fresh repair. The catheter drains into the diaper.
Antibiotics are often given while the catheter is in place. Younger boys seem to have less discomfort after repair. When the surgery is done at 6 to 12 months of age, as most pediatric urologists recommend, the child doesn't even remember it. Older boys handle this surgery well, also, especially with the types of drugs we now have to treat pain. In some cases, medication may be needed to treat bladder spasms.
The complication rate in boys with distal hypospadias repair is less than 1 in Problems happen more often after a proximal correction. The most common problem after surgery is a hole "fistula" forming in another place on the penis. This is from a new path forming from the urethra to the skin. Scars can also form in the channel or the urethral opening. These scars can interfere with passing urine. If your child complains of urine leaking from a second hole or a slow urinary stream after hypospadias repair, he should see his pediatric urologist.
Most complications appear within the first few months after surgery. But fistulas or blocks might not be found for many years. Most problems are easily fixed with surgery after the tissues have healed from the first operation often at least 6 months. It's not easy to think about more surgery in these unusual cases. But there are options that offer hope for success.
Unhealthy scarred tissues from prior operations can be removed and replaced with fresh tissue from another part of the body most often from inside the cheek. This can create a working urinary channel and still look normal. Many pediatric urologists believe that routine office check-ups aren't needed after the first few months because the risk for problems past then is so low.
Others think boys should be seen throughout childhood until after puberty. You and your son's health care provider will decide what's best. In about 7 out of children with hypospadias, the father also had it.
The chance that a second son will be born with hypospadias is about 12 out of If both father and brother have hypospadias, the risk in a second boy increases to 21 out of Many parents ask if surgery is needed for mild forms of hypospadias. It's hard to predict problems a baby will have later in life. But there are many reasons for recommending correction, no matter how severe the condition. Most pediatric urologists today suggest fixing all but the most minor forms of hypospadias.
In most cases, the benefits of correction far outweigh its risks. Hypospadias repair is done while the patient is asleep, under general anesthesia. Many anesthesiologists or surgeons also use nerve blocks near the penis or in the back to reduce discomfort when the child wakes up after surgery. These forms of anesthesia are very safe, especially when given by anesthesiologists who specialize in the care of children. Today, it's thought safe to do surgeries such as hypospadias repair in otherwise healthy infants.
The method your son's urologist chooses will depend on a number of factors. These include the degree of hypospadias and how much the penis curves. The surgeon won't know the complete situation until the operation is under way.
Surgeons who do hypospadias repair must be familiar with many techniques. Sometimes even a mild distal hypospadias may turn out to need a more complex repair. Most hypospadias repairs are done by pediatric urologists with special training and skill. Hypospadias repair wounds don't call for special care to heal the right way. The surgeon may choose from many band age types or not use any at all. The surgeon will instruct you on care of the wound and bathing.
If your son has a catheter, it may be left to drain into diapers. Diapers can be changed as usual. If your son is older, the catheter may be connected to a bag.
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Hypospadias | Pediatric Urology | Children's Hospital at Dartmouth-Hitchcock (CHaD)
In meatal stenosis the meatus, or opening at the tip of the penis, becomes narrower. This condition can be present at birth or it can occur later in life, usually between ages three and seven. Meatal stenosis is almost always seen in males who have been circumcised. Circumcision is the surgical removal of the foreskin over the tip of the penis. It is rare for uncircumcised males to have meatal stenosis. This may mean that circumcision has caused the meatus to become narrower.
Other causes of meatal stenosis include:. Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services.
Meatal Stenosis Meatal stenosis is the narrowing of the meatus, which is the opening on the tip of the penis. This condition usually is found in circumcised males. Urology What is meatal stenosis? How common is meatal stenosis? What causes meatal stenosis? The symptoms of meatal stenosis occur as a result of urine flow becoming partly blocked. Symptoms include the following: Pain or burning while urinating Sudden urges to urinate Having to urinate often A small, narrow, very fast urinary stream A urinary flow that sprays usually upward or is difficult to aim Trouble with fully emptying the bladder A drop of blood at the tip of the penis after urinating Next: Diagnosis and Tests Share Facebook Twitter LinkedIn Email Print.