Hypospadias

Hypospadias is a birth condition where the opening of the urine tube (urethra) is not at the tip of the penis. Instead, it opens somewhere on the underside of the penis, the scrotum, or near the base. The foreskin may also look incomplete — like a "hood".

Based on where the opening is:

• Distal / subcoronal: near the tip — most common and mildest
• Mid-shaft: middle of the penis
• Proximal: near the base or scrotum — may need more surgeries

• Urine opening not at the tip of the penis
• Urine stream sprays or goes downward
• Curvature of the penis when erect — called "chordee"
• Incomplete foreskin
• May have difficulty standing to urinate later

Physical examination by a paediatric surgeon at birth. In most cases no blood tests or scans are needed.

Surgery — hypospadias repair — is the only treatment. No medicines can correct it.

• Best age: 6 months to 18 months, before the child starts toilet training
• Surgery time: 1.5 to 3 hours under general anaesthesia
• Hospital stay: 1–2 days; a catheter stays for 5–7 days
• Goals: straighten the penis, move the urine opening to the tip, and a good cosmetic appearance
• Success rate: over 90% for distal cases; proximal cases may need 2 stages

• Keep the dressing clean and dry; sponge bath only
• Don't pull or touch the catheter
• Avoid diaper rash — change diapers frequently
• No cycling or rough play for 3–4 weeks
• Follow-up visits are a must