F1000 Commentary: Treatment of adults with complications from previous hypospadias surgery / What is hypospadias?

In most males, the opening on the penis for urinary drainage is at the tip of the penis, near the center of what is called the “glans penis” (or, in more common terminology, the “head” of the penis). Some males develop in the womb in such a way that the opening (called the “urinary meatus”) is on the underside of the penis, at the base of the penis, or on the scrotum. When the male urinary meatus is located in one of these atypical positions, the condition is called hypospadias.The causes of hypospadias vary. Hypospadias may be caused by a genetic condition and it may sometimes be caused by environmental conditions to which a woman is exposed while she is pregnant with a male fetus. Much of the time it isn’t clear why a boy has been born with hypospadias.

If the urinary opening is not on the tip of the glans (“head” of the penis) but is on the side of the glans, the condition is called “first degree hypospadias.” Most boys and men who have hypospadias have this form.

If the urinary opening is not on the glans (head) of the penis, but is on the underside along the shaft of the penis, the condition is called “second degree hypospadias.”

If the urinary opening is not on the penis but is on the scrotum, the condition is called “third degree hypospadias.” This is the least common form of hypospadias.

Hypospadias is generally considered to be the most common DSD in males. Some estimates put its frequency at one in every 150 male births. Frequency estimates actually depend on how exactly one defines normal penile anatomy, because as suggested in the definition above for first-degree hypospadias, what counts as hypospadias depends on how strictly one defines a “normal” location for the male meatus. (Some clinicians have suggested that too many boys are diagnosed as having hypospadias because clinicians have too strict a notion of “normal” for meatus location.)

The main support group for hypospadias is the Hypospadias and Epispadias Association. Click here for their website.

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