Hypospadias

Key points

  • Hypospadias (hype-oh-spay-dee-us) is a birth defect where the location of the opening of the urethra is not at the tip of the penis.
  • Most cases of hypospadias need surgery to correct the defect.
  • Researchers estimate that about 1 in every 150 boys has hypospadias at birth in the United States.

What it is

Hypospadias is when the location of the urethra's opening is not at the tip of the penis. The urethra forms abnormally during weeks 8–14 of pregnancy.

What is the urethra?‎

The urethra is the tube that carries urine from the bladder to the outside of the body.

The abnormal opening can form anywhere from just below the end of the penis to the scrotum. Boys with hypospadias

  • Can sometimes have a curved penis
  • Could have problems with abnormal spraying of urine and might have to sit to urinate
  • May have a testicle that has not fully descended into the scrotum.

Hypospadias can lead to problems later in life if untreated. Examples are difficulty performing sexual intercourse or difficulty urinating while standing.

Types

The type of hypospadias depends on the location of the opening of the urethra.

Subcoronal

The location of the opening of the urethra is near the head of the penis.

Midshaft

The location of the opening of the urethra is along the shaft of the penis.

Penoscrotal

The location of the opening of the urethra is where the penis and scrotum meet.

Medical illustration of hypospadias showing the 3 types, Subcoronal (opening of the urethra is located near the head of the penis), Midshaft (opening of the urethra is located along the shaft of the penis), Penoscrotal ( opening of the urethra is located where the penis and scrotum meet).
There are degrees of hypospadias, ranging from minor to severe.

Risk factors

The causes of hypospadias among most infants are unknown. CDC researchers have reported findings about some factors that affect the chance of having a baby with hypospadias:

  • Maternal age of 30 years or older1
  • Maternal BMI classified as overweight or obese1
  • Use of assisted reproductive technology to conceive (ART)2
  • Maternal use of certain hormones (progestins) just before or during pregnancy3

Diagnosis

Providers usually diagnose hypospadias during a physical examination after the baby's birth.

Treatment

Treatment for hypospadias depends on the type of defect the boy has. Most cases of hypospadias will need surgery to correct the defect.

Boys usually have surgery between the ages of 3–18 months old if needed. In some cases, their surgeries are in stages. Some of the repairs done during the surgery may be

  • Placing the opening of the urethra in the right place
  • Correcting the curve in the penis
  • Repairing the skin around the opening of the urethra

The doctor might need to use the foreskin to make some of the repairs. This means doctors should not circumcise baby boys with hypospadias.

Resources

The views of this organization are its own and do not reflect the official position of CDC.

Hypospadias and Epispadias Association (HEA): HEA offers support and education for people born with hypospadias or epispadias and their families.

  1. Carmichael SL, Shaw GM, Laurent C, Olney RS, Lammer EJ, and the National Birth Defects Prevention Study. Maternal reproductive and demographic characteristics as risk factors for hypospadias. Paediatr Perinat Epidemiol. 2007; 21: 210–218.
  2. Reefhuis J, Honein MA, Schieve LA, Correa A, Hobbs CA, Rasmussen SA, and the National Birth Defects Prevention Study. Assisted reproductive technology and major structural birth defects in the United States. Human Rep. 2009; 24:360–366.
  3. Carmichael SL, Shaw GM, Laurent C, Croughan MS, Olney RS, Lammer EJ. Maternal progestin intake and risk of hypospadias. Arch Pediatr Adolesc Med. 2005;159: 957–962.
  • Chen MJ, Karaviti LP, Roth DR, Schlomer BJ. Birth prevalence of hypospadias and hypospadias risk factors in newborn males in the United States from 1997 to 2012. Journal of pediatric urology. 2018 Oct 1;14(5):425-e1.
  • Mai CT, Isenberg J, Langlois PH, Alverson CJ, Gilboa SM, Rickard R, Canfield M, Anjohrin SB, Lupo PJ, Jackson DR, Stallings EB, Scheuerle AE, Kirby RS for the National Birth Defects Prevention Network. Brief report, Population-based birth defects data in the United States, 2008 to 2012: Presentation of state-specific data and descriptive brief on variability of prevalence. Birth Def Res (Part A). 2015; 103:972-994.