Renal/ Urinary

Question 1

What is hypospadias?

Answer 1

Hypospadias is an abnormality of the urethra and penis that is present at birth. This can cause problems with passing urine and also with erections. It can range in severity. Surgical correction is usually very successful.

Question 2

What are the different severities of hypospadias?

Answer 2

The main problem is that the urethra opens on the underside of the penis instead of at the end of the penis. The opening can be anywhere from just below the normal position (mild) to as far back as the base of the scrotum (severe).

Hypospadias may also include the following:

• A hooded appearance of the foreskin. This is because the foreskin does not develop on the underside of the penis.
• Tightening of the tissues on the underside of the penis (called ‘chordee’). This pulls the penis down and it cannot fully straighten. The further back the urethral opening is, the more severe the chordee tends to be. Mild hypospadias may not have any chordee.

Question 3

Symptoms of hypospadias?

Answer 3

-Passing urine is different to normal. A baby in nappies will have no problem. However, when older, the urine stream may not be able to be directed forward into a urinal. When going to the toilet the urine is likely to ‘spray’ backwards. Sitting on a toilet may be needed to pass urine without mess.
-Chordee which causes bending of the penis. This is more noticeable when the penis is erect. Sexual intercourse -may be difficult or impossible in severe cases.
Psychological problems about being ‘different’ to normal are common.
-Mild erection difficulties and premature ejaculation have been reported in adulthood in patients who have had surgery for hypospadias in childhood.