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Hypospadia is a birth defect in which the opening of the urethra, which is normally found on the tip of the penis, is located instead on its underside. This is important when trying to conceive, since the urethra carries semen out of the body.
Curvatures of the penis (called chordee) may also be present in this condition, making sexual intercourse difficult. Males with hypospadia are also more likely to be born with an undescended testicle, which is considered another cause of male infertility.
Rates of Hypospadia
Hypospadia occurs rarely. It is present in around one out of every 250 live male births. Different types of hypospadia can occur, resulting in urethra openings that range from just below the end of the penis to the scrotum.
Causes of Hypospadia
The exact causes of hypospadia are not yet known. Researchers believe that there may be a genetic component to hypospadia, since studies have shown that it is more common in twins.
Another theory is that hypospadia may be influenced by hormones. Some scientists believe that hormones that influence male characteristics, such as testosterone, may affect the development of the urethra. Other studies have found that women who were exposed to hormones like progesterone and estrogen during their pregnancy may be more likely to give birth to boys with hypospadia.
Hypospadia is usually diagnosed when the male is a newborn, through a physical examination by the baby’s doctor. If hypospadia is suspected, the doctor may order a test called an excretory urogram. This is an X-ray test that provides pictures of the urinary tract, as well as the kidneys and bladder.
Hypospadia is usually treated by surgery within the first year of life. Hypospadia surgery can include repositioning the urethra, placing the urethra opening at the head of the penis, and reconstructing the skin around the opening. The surgeon will reroute the urethra opening to the head of the penis.
Hypospadia surgery can also be done as an adult, though it is best done in infants and young children. Some surgeries are easier than others, depending on the location of the urethral opening.
Complications are more likely in adults, and can include bleeding, infection, narrowing of the urethra, and curvature of the penis.
Pregnancy and Hypospadia
Fertility problems should no longer remain after the hypospadia is surgically corrected. After surgery, the curve of the penis should be straightened and proper forward ejaculation should be achieved.