Premium Nahrungsergänzungsmittel | artgerecht

Hypospadias: Causes, Symptoms & Treatment

Hypospadias is a congenital condition in males where the urethral opening is located on the underside of the penis rather than at the tip.

Regular tips about health Regular tips about health

Things worth knowing about "Hypospadias"

Hypospadias is a congenital condition in males where the urethral opening is located on the underside of the penis rather than at the tip.

What is Hypospadias?

Hypospadias is one of the most common congenital abnormalities of the male urinary tract. In this developmental condition, the urethral opening (urethral meatus) is not located at the tip of the glans penis but instead on the underside of the penis. The severity of the condition depends on how far the opening is from its normal position. Hypospadias occurs in approximately 1 in 200 to 300 male newborns, making it one of the most frequent urological anomalies in childhood.

Types and Severity

Hypospadias is classified based on the location of the urethral opening:

Distal (anterior) hypospadias: The urethral opening is near the glans or the front of the penile shaft. This is the most common and mildest form, accounting for approximately 70% of all cases.
Middle (midshaft) hypospadias: The opening is located in the middle of the penile shaft.
Proximal (posterior) hypospadias: The opening is located near the base of the penis, on the scrotum, or even in the perineal area. This is the most severe form.

Hypospadias is frequently associated with a downward curvature of the penis known as chordee. Additionally, the foreskin may be incompletely developed, resulting in a characteristic "dorsal hood" appearance.

Causes

The exact causes of hypospadias are not fully understood. Both genetic and environmental factors are thought to play a role:

Genetic factors: A family history of hypospadias increases the risk; fathers or brothers of affected individuals have a higher likelihood of also being affected.
Hormonal disruptions: Impaired androgen (male hormone) activity during early pregnancy can interfere with normal urethral development.
Environmental factors: Exposure to certain chemicals known as endocrine disruptors during pregnancy is considered a potential risk factor.
Premature birth and low birth weight may also increase the risk.

Diagnosis

Hypospadias is typically diagnosed shortly after birth during a routine physical examination. The pediatrician or neonatologist identifies the abnormal position of the urethral opening and any associated penile curvature. In more severe cases, additional investigations such as renal ultrasound and genetic testing may be recommended to rule out associated anomalies.

Important: Circumcision should be avoided in newborns diagnosed with hypospadias, as the foreskin tissue may be needed as surgical material during reconstructive surgery.

Treatment

The primary treatment for hypospadias is surgical correction. The goals of surgery include:

Repositioning the urethral opening to the tip of the penis (urethroplasty)
Straightening the penis if chordee is present
Reconstructing the foreskin if desired
Ensuring a normal urinary stream and sexual function in adulthood

The optimal age for surgery is typically between 6 and 18 months of life. At this stage, tissue is highly adaptable and the child has not yet developed an awareness of the procedure. Distal forms often require only a single operation, while more severe forms may need multiple procedures.

Surgical Techniques

Several surgical techniques are available, chosen based on the severity and location of the urethral opening. These include the Tubularized Incised Plate (TIP) urethroplasty (Snodgrass technique), the onlay technique, and other reconstructive approaches. The choice of technique is made by the treating pediatric surgeon or pediatric urologist.

Prognosis and Long-Term Outlook

With timely and appropriate surgical treatment, the prognosis for most children with hypospadias is excellent. The majority of individuals can expect normal urinary function and sexual function in adulthood. In more severe cases, secondary corrective procedures may be necessary, and long-term follow-up is recommended to detect late complications such as urethral strictures early.

References

German Society of Pediatric Surgery (DGKCH) - S2k Clinical Guideline on Hypospadias (2020).
Springer, A. et al. - Prevalence, risk factors and hormone receptor expression in hypospadias. European Journal of Pediatrics, 2016.
Baskin, L.S. - Hypospadias. In: UpToDate, Wolters Kluwer, 2023.

Building Blocks for a Healthy Life

As an integrated manufacturer, we develop & produce evidence-based, patented, and non-patented formulations. We work exclusively with plant and natural extracts according to the strictest purity & quality standards.
The combination of science & modern technology with the laws of nature creates solutions consistently tailored to humans – for the highest good: health.