Hypospadias In Infants

Quick Answer

If your baby boy has been diagnosed with hypospadias, please know that this is a common and treatable condition! Hypospadias occurs in about 1 in 250-300 baby boys. It means the urethral opening (where urine comes out) is not at the tip of the penis but somewhere along the shaft. Surgery can successfully correct this, and most boys go on to have completely normal urinary and sexual function.

Understanding Hypospadias

What is Hypospadias?

• Birth defect affecting the penis
• Urethral opening (meatus) is in wrong position
• Not at the tip, but somewhere along shaft or scrotum
• Occurs during fetal development (9-12 weeks pregnancy)
• Very common - you’re not alone! Types Based on Location:

Type	Location	Severity
Distal/Glanular	Near tip of penis	Mild (most common - 70%)
Midshaft	Along middle of penis	Moderate
Proximal/Penoscrotal	Near base of penis/scrotum	More severe

Why This Happens

Causes (Usually Unknown):

• Exact cause unclear in most cases

• Development issue during weeks 9-12 of pregnancy

• Genetic factors may play role

• May run in families

• NOT caused by anything you did during pregnancy! Risk Factors:

• Family history of hypospadias

• Older mother (35+)

• Maternal obesity

• Certain fertility treatments

• Environmental factors (rarely proven) Important: In most cases, no specific cause is found. Don’t blame yourself!

What You May Notice

Signs of Hypospadias:

• Urethral opening not at tip of penis

• “Hooded” foreskin (skin only on top, incomplete underneath)

• Downward curve of penis (chordee)

• Abnormal spray when urinating

• May need to sit to urinate (if severe) Usually Noticed:

• At birth during examination

• During newborn checkup

• Sometimes missed until diaper changes

When to Worry (Red Flags)

Contact your pediatrician/urologist if:

• Difficulty urinating

• Pain during urination

• Infection signs (fever, redness, swelling)

• Concerns about appearance

• Questions about treatment timing Important Notes:

• Do NOT circumcise before consulting urologist

• Foreskin may be needed for surgical repair

• Discuss with pediatric urologist first

Treatment: What to Expect

Surgery is the Standard Treatment:

Aspect	Details
Age for Surgery	Usually 6-18 months (ideal: 6-12 months)
Type	Usually single surgery, sometimes staged
Duration	1-3 hours depending on severity
Hospital Stay	Often same-day or overnight
Recovery	2-4 weeks, full healing in 6 months

Goals of Surgery:

• Place urethral opening at tip of penis

• Straighten any curve (chordee)

• Create normal appearance

• Allow normal urination standing up

• Ensure future sexual function Before Surgery:

• No circumcision (foreskin used for repair)

• Regular pediatric urologist visits

• Plan timing around family schedule

• Prepare for post-operative care

Post-Surgery Care

Immediately After:

• Catheter may be in place (usually 1-2 weeks)

• Dressing/bandage on penis

• Pain medication as needed

• Avoid straddling toys (no car seats for prolonged time) Wound Care:

• Keep area clean and dry

• Change diaper frequently

• Watch for signs of infection

• Follow specific surgeon instructions What to Expect:

• Swelling and bruising (normal)

• Some bloody drainage (normal)

• Child may be fussy initially

• Healing takes several weeks Concerning Signs (Call Doctor):

• Fever over 38.5°C

• Heavy bleeding

• Unable to urinate

• Severe pain not relieved by medication

• Signs of infection (pus, increasing redness)

What You Can Do

Before Surgery:

• Find experienced pediatric urologist

• Ask questions about their experience

• Understand the procedure

• Plan for recovery time at home

• Arrange help for post-op period Emotionally:

• Know this is common and treatable

• Outcomes are generally excellent

• Your son will likely have normal function

• Connect with other parents if helpful

• Don’t feel guilty - this isn’t anyone’s fault Practical:

• Document doctor’s instructions

• Prepare home for recovery

• Stock up on diapers and soft clothing

• Plan for time off work if needed

Long-Term Outcomes

Good News:

• Surgery success rate is high (90%+)

• Most boys have normal urination

• Sexual function usually normal

• Fertility usually unaffected

• Cosmetic results generally good Possible Complications (Uncommon):

• Fistula (extra opening) - may need minor repair

• Stricture (narrowing) - may need follow-up

• Some may need second surgery

• Regular follow-up recommended

Frequently Asked Questions

Q: Doctor ne bola hai ki baby ka operation hoga - kya yeh safe hai?

A: Yes, hypospadias surgery is very safe when done by an experienced pediatric urologist. It’s one of the most common pediatric urological surgeries. The techniques have improved significantly over decades. Complications are uncommon, and most boys have excellent outcomes with normal function.

Q: Why didn’t they do circumcision at birth like other babies?

A: In hypospadias, the foreskin is often incomplete (looks “hooded”). More importantly, the foreskin tissue is valuable for surgical repair - surgeons use it to reconstruct the urethra. Circumcising would remove tissue needed for surgery. Always consult the urologist before any decision about circumcision.

Q: Will my son have normal sexual function as an adult?

A: Yes, in the vast majority of cases! When surgery is done properly, boys grow up to have normal sexual function and fertility. The goal of surgery is to ensure normal appearance and function. Most men with repaired hypospadias have normal intimate lives and can father children.

Q: At what age should surgery be done?

A: Most pediatric urologists recommend surgery between 6-18 months of age. This timing is ideal because: healing is faster in young babies, child won’t remember the surgery, and psychological impact is minimized. Earlier surgery also completes treatment before potty training age. Your surgeon will recommend best timing for your child.

Q: Kya yeh condition next baby mein bhi ho sakti hai?

A: There is a slightly higher risk if one child has hypospadias. If one son is affected, the risk for the next male child is about 10-15% (compared to 0.3% in general population). If the father had hypospadias, risk is about 8%. However, most subsequent male babies will NOT have it. Talk to a genetic counselor if you’re planning another pregnancy.

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This article was reviewed by a pediatrician. Last updated: January 2025

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