Hypospadias is a condition that affects the development of the urethra in boys. The urethra is the tube that carries urine from your bladder to the outside of your body. Hypospadias causes the opening of the urethra to develop in the wrong place.
This information has been written for parents of boys who have hypospadias.
Hypospadias is a congenital condition, which means it's something you're born with. About one in 300 boys in the UK are born with hypospadias. Hypospadias affects the way the urethra develops. The urethra is the tube that passes urine and semen out of the body. It runs from the bladder through the prostate gland and along the centre of the penis.
If your son has hypospadias, it means the opening through which urine is passed doesn't come out at the tip of your son's penis, but instead, opens at a point somewhere on the underside of his penis.
There are several different types of hypospadias, depending on where the opening of your son's urethra is positioned.
Glanular, coronal and subcoronal hypospadias are the most common – about seven out of 10 boys with the condition have one of these types.
If your son has hypospadias, he may also have other associated problems, including:
The further away from the tip of the penis the opening of your son's urethra is, the more severe these problems may be, resulting in more complex surgery being needed to correct the condition.
You may notice that your son's urine doesn't come out of the tip of his penis. However, this can be difficult to spot if your child is in nappies or the condition is very minor. If you're concerned, talk to your GP.
As your son gets older, he may find it difficult to direct his urine stream, leading to spraying or dribbling, and may need to sit down to pass urine. Also, his erections may be bent and uncomfortable, making sexual intercourse in adulthood difficult.
Hypospadias can be associated with other conditions, most commonly:
Very rarely, a combination of hypospadias and undescended testes can be a sign of an intersex condition. This is when an underlying sex development disorder causes uncertainty over the gender of a child. Speak to your GP for more information.
The exact causes of hypospadias aren't fully understood at present. More research is needed to confirm the various theories that have been suggested but it's thought that the following factors may be involved.
It’s thought that hypospadias may be caused by a combination of genetic and environmental factors.
Usually, hypospadias is picked up during your son's first medical check (postnatal examination). However, if he has only very minor glanular hypospadias, it may not be diagnosed until he is older. See our frequently asked questions for more information.
Once your son has been diagnosed with hypospadias, he will be referred to a paediatric urologist for treatment. A paediatric urologist is a doctor who specialises in identifying and treating conditions of the urinary tract in children.
If your son has a more severe form of hypospadias, he may need to have an ultrasound scan to examine his kidneys and bladder to check they are working properly.
If your son has only minor glanular hypospadias, he may not need any treatment other than regular monitoring.
More severe types of hypospadias are treated using surgery to correct the condition. Surgery for hypospadias is commonly carried out when your son is aged between four and 18 months. Surgery can be done when your son is older so he can decide for himself, and even once he reaches adulthood. However, there appears to be a greater risk of complications when the surgery is left until later. Doing surgery later may also lead to psychological problems related to sexuality.
Surgery aims to:
If your son has minor hypospadias, he will usually only need one operation. However, if he has more severe hypospadias, he may need to have further operations, which are done a few months apart. See our frequently asked questions for more information.
Your son's foreskin may be used to rebuild his urethra during the operation, so it's important that he isn't circumcised before this surgery.
Produced by Polly Kerr, Bupa Health Information Team, November 2012.
For answers to frequently asked questions on this topic, see FAQs.
For sources and links to further information, see Resources.
This information was published by Bupa's Health Information Team and is based on reputable sources of medical evidence. It has been reviewed by appropriate medical or clinical professionals. Photos are only for illustrative purposes and do not reflect every presentation of a condition. The content is intended only for general information and does not replace the need for personal advice from a qualified health professional. For more details on how we produce our content and its sources, visit the About our Health Information page.