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Hypospadias is a congenital anomaly where the urethral opening (meatus) is located on the ventral aspect of the penis rather than at the tip of the glans. This condition affects approximately 1 in 200-300 male births and can range from mild cases with the meatus just below the glans to severe cases where it opens at the base of the penis or scrotum.
Hypospadias results from incomplete fusion of the urethral folds during the 8th to 14th weeks of fetal development, when testosterone and dihydrotestosterone normally stimulate urethral tube closure. The condition may be associated with chordee (ventral curvature of the penis) due to fibrous tissue replacing normal tissue, and can occur alongside other genitourinary anomalies.
Diagnosis is typically made at birth through physical examination, noting the abnormal position of the urethral meatus and assessing for associated findings like chordee or bifid scrotum. The severity classification (anterior, middle, or posterior) determines surgical timing and approach, with most cases requiring surgical repair between 6-18 months of age to optimize functional and cosmetic outcomes while minimizing psychological impact.