Hypospadias

Key points

  • Hypospadias (hype-oh-spay-dee-us) is a birth defect where the opening of the urethra isn't located at the tip of the penis.
  • Most cases of hypospadias will need surgery to correct the defect.
  • Researchers estimate that about 1 in every 150 baby boys is born with hypospadias in the United States.

What it is

Hypospadias is when the opening of the urethra is not located at the tip of the penis. The urethra is the tube that carries urine from the bladder to the outside of the body.

In boys with hypospadias, the urethra forms abnormally during weeks 8–14 of pregnancy. 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. They could have problems with abnormal spraying of urine and might have to sit to urinate. In some boys with hypospadias, the testicle has not fully descended into the scrotum. If hypospadias is not treated it can lead to problems later in life. These can include 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 opening of the urethra is located somewhere near the head of the penis.

Midshaft

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

Penoscrotal

The opening of the urethra is located 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 risk 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 conceive2
  • Maternal use of certain hormones (progestins) just before or during pregnancy3

Diagnosis

Hypospadias is usually diagnosed during a physical examination after the baby is born.

Treatment

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

If surgery is needed, it is usually done when the boy is between the ages of 3–18 months old. In some cases, the surgery is done in stages. Some of the repairs done during the surgery might include:

  • 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 a baby boy with hypospadias should not be circumcised.

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.