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Hypospadias

Urine exits the body through a tube called the urethra which, in men, normally opens at the tip of the penis. In some male babies, however, the urethra exits the penis through an opening somewhere along the underside of the penis, or possibly even further back towards the body.

Often babies born with hypospadias also have an associated condition known as chordee, in which the penis is bent when erect. This can cause problems with sexual function later in life.

While hypospadias is usually corrected during infancy, in some cases it is not addressed until later in life. Also, although in most cases one surgery corrects the issue without later complications, in some cases later treatments may be required (see below).

Urologists at UMass have many years of experience managing pediatric urology conditions and will treat your child with compassionate care.  Hypospadias is corrected with surgery done under general anesthesia. The surgery is best done when the child is roughly a year old. It may be done later if the child has more pressing health issues or if his growth is delayed. The procedure involves constructing an extension of the urethra to the tip of the penis. This is usually done using the foreskin. If there isn't enough foreskin, the urologist may use tissue taken from inside the cheek to extend the urethra. During surgery, the urologist will also be able to determine whether or not the penis would be bent during erection, and, if so, correct that condition at the same time.

The most common complication requiring a second procedure is the development of a small hole called a "fistula" between the newly constructed part of the urethra and the skin. Urine will then leak out of this hole during urination. Fistulas can be repaired with additional minor surgery. 

Later complications may involve a narrowing of the urethra, called a "stricture," or a bend in the penis during erection.

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