⚠️ This log is a personal documentation and not medical advice. Always consult your child’s surgeon or pediatric urologist for individualized care. As patients or parents of patients, the emotional impact of a hypospadias diagnosis can be significant. I remember feeling shocked, confused, guilty, and depressed for years. I wished for information that was factual and calm—something that could help soften the emotions that come with hearing unfamiliar medical terms about the child. This is my attempt to share what I’ve learned, grounded in reliable medical sources, for parents who may be standing where we once stood.
What is hypospadias?
Hypospadias is a congenital condition, meaning it is present at birth, in which the opening of the urethra (the meatus) is located on the underside of the penis rather than at the tip.
It is one of the most common congenital conditions in boys, occurring in approximately 1 in 200–300 male births, although it is rarely discussed publicly. The location of the urethral opening can vary, and in clinical practice the final classification is often confirmed after correction of any associated chordee:
- Distal (mild): near the tip of the penis
- Midshaft: along the penile shaft
- Proximal (more severe): near the scrotum or perineum
Hypospadias may also be associated with:
- Chordee, a downward curvature of the penis
- A hooded foreskin
Hypospadias does NOT affect a child’s intelligence, growth, or overall health. Many boys with hypospadias are otherwise completely healthy.
What causes hypospadias?
Hypospadias develops during early fetal development, typically between 8 and 14 weeks of pregnancy, when the urethra and external genitalia are forming. Medical research shows that hypospadias has a multifactorial cause, meaning several factors may be involved rather than a single explanation. These may include:
- Hormonal factors, particularly those involving androgen signaling
- Genetic influences, as hypospadias occurs more often in some families
- Environmental factors, which are still being studied and not conclusively proven
What doctors emphasize—and what many parents need to hear—is that there is no evidence that anything a parent did or did not do caused hypospadias. Feelings of guilt are common, but they are not supported by medical evidence.
When is surgery recommended?
Surgery for hypospadias may not be required in every case. The decision depends on the severity of the condition and is made in consultation with multiple pediatric urologists, often after careful discussion and second opinions.
Surgical repair may be recommended when hypospadias is expected to cause:
- Difficulty directing urine
- Significant penile curvature (chordee)
- A urethral opening far from the tip of the penis
- Potential reproductive or sexual function concerns later in life
- Psychosocial concerns as the child grows
When surgery is recommended, it is most often performed between 6 and 18 months of age, a timeframe supported by pediatric surgical and anesthesia research. Long-term studies show high success rates and low complication risks when surgery is performed by experienced pediatric urologists, making surgeon experience an important consideration once a surgical decision is made.
As a parent, it helped me to know that:
- Surgery is planned and elective, not an emergency
- Decisions are individualized—there is no single right path
- Asking questions and taking time to decide are encouraged
Reference
-
Cleveland Clinic.
Hypospadias: Causes, Symptoms, Diagnosis & Treatment
https://my.clevelandclinic.org/health/diseases/15060-hypospadias -
Mayo Clinic.
Hypospadias
https://www.mayoclinic.org/diseases-conditions/hypospadias/symptoms-causes/syc-20355148 -
Boston Children’s Hospital.
Hypospadias
https://www.childrenshospital.org/conditions/hypospadias -
National Institutes of Health (NIH) – MedlinePlus.
Hypospadias
https://medlineplus.gov/ency/article/001285.htm -
Baskin LS, Ebbers MB.
Hypospadias: anatomy, etiology, and technique.
Journal of Pediatric Surgery, 2006.
https://pubmed.ncbi.nlm.nih.gov/16677877/
