Physical Problems in Males

Hypospadia

Hypospadia: Four of its possible forms. Click on picture

Hypospadia (from gr. hypo: “under” + spadon: “slit”, “break”, or “gash”) is a congenital malformation of the male sex organs: The urethra does not open through the glans of the penis, but somewhere through the underside of the penis shaft or even at the base of the penis. As a result, it is difficult to urinate normally, i.e. to control the stream of urine.
The cause of hypospadia is some hormonal imbalance or deficiency during a certain critical period before the boy is born. Because of this imbalance, the formation of his sex organs could not be properly completed. In addition to prenatal hormonal problems, various genetic and environmental factors may also contribute to this malformation. In mild cases of hypospadia the urethral opening is small and lies rather close to the tip of the glans; in severe cases, the opening is more of a gap and lies close to the base of the penis. Very often, the penis is curved, bending downward. There may also be a connection with other physical problems, for example undescended testicles and intersexuality (see there). The number of males affected is relatively small (an estimated 1 in 300), but it seems to be rising in several countries. (Very rarely, a comparable condition is found in females: Because of a malformed or missing urethra, the bladder empties into the vagina.) Severe and complicated cases of hypospadia may be related to the more serious problem of intersexuality.

Treatment
In most cases (exception: intersexuality), early corrective surgery is the appropriate treatment. For various medical reasons, it is best performed before the boy reaches the age of three.