Hypospadias

Hypospadias is the most prevalent congenital anomaly in children, impacting the entire penis, not just the urethra. It’s a birth defect found in males where the urethral opening isn’t located at its usual spot at the tip of the penis. Instead, it might be found lower down the shaft, on the scrotum, or in the perineal area. The condition presents in various forms, from mild to severe, indicating the urethral opening’s location can vary significantly, sometimes even being closer to the scrotum.

Typically, hypospadias is identified during routine newborn check-ups. For more complex cases, specialized evaluations are necessary to meticulously plan the surgical correction. Features that might indicate different types of hypospadias include:

The urethral opening positioned lower, sometimes at the glans level,
An underdeveloped glans and a missing lower part of the foreskin,
Shorter skin on the underside of the penis beneath the urethral opening, with the upper skin and foreskin appearing normal,
A downward curvature of the penis during full erection, which is common in most affected children. In some instances, noticeable fatty tissue in the pubic region may further obscure the penis.

Surgical intervention is the primary treatment for hypospadias. These procedures tend to be surface-level and minimally invasive, though they involve intricate work due to the penis’s small and sensitive structures. Surgery is recommended after the child turns two, when anatomical structures have matured, and anesthesia risks are minimized. The surgical goals aim to:

Create a broad, functional urethra with its opening positioned at the glans tip,
Straighten any penile curvature,
Reconstruct the penile skin, often requiring skin transfer from the top to the bottom,
In cases where excessive pubic fat is present, partial removal might be necessary.