What is Hypospadias?
• Hypospadias is one of the common birth defects affecting the external male genitalia
• It is characterized by the abnormality in the location of the opening of the urethra (urethral meatus) on the penis (the urethra is a tube like structure which runs through the length of the penis and opens to the outside at the tip of the penis. It carries urine from the bladder and semen from the ejaculatory ducts)

Structural Defects
• In Hypospadias the urethral meatus is abnormally placed on the undersurface of the penis and the more severe the condition the meatus is located further away from the tip. In severe conditions the opening can even be located in the scrotum (loose skin bags which contain the testicles) or the perineum (area of skin between the scrotum and the anus)
• This condition is often associated with the deformity of the penis known as chordee (bending of the penis)

Problems caused by it
• There is no known cause for this condition and even though a genetic link has not been established it can run in families
• Hypospadias will render the child unable to pass urine while standing which in older children can be harmful to their normal social development
• The associated bend in the penis can hinder normal reproductive health and sexual function

Diagnosis
• It is usually diagnosed by your doctor upon a clinical exam and may not require any further testing
• However in more severe cases the doctor may ask for an ultrasound and further investigations to rule out any associated syndromes
• Your child will be referred to a pediatric urologist/pediatric surgeon for further management
• Once diagnosed it is a good idea not to circumcise as the foreskin may be required in the surgical correction

Management
• The treatment is usually a surgical repair wherein the urethra is extended to open at its normal position and correction of the abnormal shape or bend of the penis
• The surgery can happen in one or two stages depending upon the severity of the condition
• The ideal age to do the correction in a full term, otherwise healthy baby is anywhere between 3-18 months
• Correction can also be done in older kids and adults however caring for the wound is much easier when the child is still in diapers
• The severity of the Hypospadias determines how much normalcy can be obtained post-surgery

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