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Hypospadias (urinary opening under the penis)

The urinary opening sits below the tip of the penis. Do not circumcise before a surgeon has examined the child.

Diagram comparing the usual position of the urinary opening with hypospadias
Usual urinary opening (left) and hypospadias (middle) (diagram). Fwltur Gwydr, Wikimedia Commons, CC BY-SA 4.0
Diagram of the places where the urinary opening can lie in hypospadias
Where the urinary opening can lie in hypospadias (diagram). Charles G Macias, Wikimedia Commons, CC BY 4.0
Hypospadias: the urinary opening is on the underside of the penis. Photograph taken by Dr. Shahinur Rahman Shaoun.

What is hypospadias?

In hypospadias the opening for urine is not at the tip of the penis but somewhere on the underside, from just below the tip to further back. It is present from birth.

What to look for

  • The urine hole is on the underside of the penis.
  • The foreskin looks like a hood, open at the back and not complete in front.
  • The penis may curve downward, especially when erect.
  • The urine stream may spray or go downward.

Before anything else

  • Do not have the child circumcised before a paediatric surgeon has examined him. The foreskin is often needed for the repair.

Treatment

Surgery reconstructs the urine channel and straightens the penis, and gives a normal-looking tip. It is generally done between about 6 and 18 months of age, under anaesthesia. Milder forms need one operation; more severe forms may need a second stage. A catheter or dressing is kept for a short time afterwards. A follow-up plan is set with the surgeon.

Common questions

Is it dangerous if left alone?

Urine flow and appearance are affected, and it may cause problems with passing urine standing up and later in life. Surgery is advised.

Can it be done as a day-care?

Some milder repairs are; others need a short stay. The surgeon decides after examining your child.

This page is for general information for parents. Every child is different: after examination and tests, an experienced paediatric surgeon decides the condition and the method of treatment. So for any problem, please consult a registered paediatric surgeon.

This photograph is published only to give educational information about the signs and treatment of the condition. The necessary verbal consent of the patient/guardian has been taken. It is not used for any sexual or entertainment purpose.