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Hypospadias (hypo-spay-dius) is an abnormality of the penis. It affects about one in 150 male babies, and is commonly detected at nascence.

The urethra is a tube connecting the float to the tip of the penis, carrying urine (wee) outside of the body. When hypospadias occurs, the end of this tube does non grade properly and the urine can come out in the incorrect place.

In most cases, the foreskin is as well underdeveloped and an abnormal curvature of the penis can occur. This can bear on self-esteem and sexual function in the time to come.

Unless it is very mild, hypospadias normally requires surgery.

Signs and symptoms of hypospadias

There are unlike types of hypospadias, depending on the symptoms. Signs that your child has hypospadias include:

• The opening of the urethra (where the urine comes from) is not at the end of the penis but is somewhere else along the penis (see the diagram below).
• The foreskin may exist all at the summit of the penis (dorsal hood) and there may exist none on the under surface.
• The penis may non be straight (it has a bend in it) – this is called a chordee.
• There is not a straight stream of urine.

While hypospadias is usually detected at nascence, in some instances information technology is non picked upward for several years. If you are concerned about your child's penis, see a GP.

Some cases of hypospadias are also associated with undescended testicles (meet our fact sheet Undescended testes).

Treatment for hypospadias

The handling options depend on how severe the hypospadias is. Sometimes your child's urinary tract will demand to be investigated to make sure that there are no other problems, particularly when the abnormality is more astringent.

Unless very mild, hypospadias is usually corrected by surgery to:

• move the pigsty (urethral opening) to the tip of the penis, and shut over the pigsty that was previously there – this will enable your kid to urinate standing upwardly and with a straight stream of urine
• correct the bend so that the penis is straight and make the penis await normal.

The age for correction is from half-dozen to 18 months of age, depending on a number of factors. You will need to talk over this with your kid'southward surgeon. More than than 1 operation may be required.

Information technology is non advisable for your kid to be circumcised before surgery. The foreskin may need to be used in the operation. If this is the case, the penis tin can be made to expect circumcised after the surgery if yous choose.

Risks and side effects of surgery

As with all surgery, at that place are some risks and potential side effects involved. These are rare, and the benefits of surgery will outweigh the risks. Some complications specific to hypospadias surgery include:

• Most children volition need a catheter or stent for about a week after the surgery. A side effect from some catheters is bladder spasms. Medication is available to assistance cease the spasms if they occur.
• There may be some bleeding from the penis.
• The wound may non heal well. Either part, or rarely all, of the wound could breakdown. Urine may then leak out of the original hole. This is called a fistula.
• The new opening may narrow, which makes information technology more than difficult to pass urine. This is chosen a stricture.
• In that location may be incomplete correction of the bend.

Surgery to right hypospadias should be only done past an experienced paediatric urologist (a doc who specialises in urinary-tract systems).

Care in hospital after surgery

• Your child volition take clear fluids going directly into a vein through a drip (intravenous or Four therapy) until they are gear up to consume and drink over again.
• If antibiotics are needed, these will be given through the drip. Your child may demand to keep taking antibiotics past mouth at dwelling house.
• Your child will be given regular pain relief.
• At that place may be a dressing around the penis. If a dressing is used, your medico will tell yous when this can come up off.

How long your child needs to stay in hospital volition depend on:

• the type of hypospadias they have
• how speedily they recover from the operation
• how comfy you are to take them home with a catheter, if they take one.

The hospital staff (doctors, nurses and specialists) will teach you how to look after the catheter at home. Make sure you understand the instructions before you become dwelling house. Ask for clarification if you lot are not certain.

Care at dwelling

• Put Vaseline in your child's nappy, or on a pad in their underpants, to stop the penis sticking to nappies or clothing. The nurses will advise you lot how to exercise this.
• Encourage your child to beverage plenty of fluids. This helps them to wee frequently, which is important.
• Give pain relief when needed. Paracetamol may exist plenty. See our fact sail Hurting relief for children.
• Give oral antibiotics as instructed.
• Follow instructions from the doctor nearly the dressing on the penis. The doctor will tell yous when it needs to be soaked off.
• Brand certain that your child doesn't practice vigorous activities until brash that it'south OK by the doctor.
• Add 2 tablespoons of cooking common salt to your kid'south bathroom water to assistance reduce swelling one time your child's doctor has advised that your child can have a bath.

Contact your doctor or treating hospital if:

• you cannot manage or control your child's pain
• your child has a temperature over 38.5ºC
• the wound becomes infected (looks red, inflamed or is oozing)
• your kid is non passing plenty urine – the wee will become very dark in colour if this happens
• you have whatever concerns about the catheter, or it comes out earlier it is due to be removed
• the dressing falls off earlier the due fourth dimension
• you are worried at all.

Key points to remember

• Hypospadias is an abnormality of the penis in which the opening of the urethra is not at the stop of the penis.
• Unless very balmy, hypospadias is ordinarily corrected by surgery.
• Surgery should be only done by an experienced paediatric urologist.
• The amount of time spent in hospital will depend on your child's recovery, and how comfortable you are caring at abode for a catheter, if required.

For more information

• Kids Health Info fact sheet: Undescended testes
• Kids Health Info fact sheet: Pain relief for children.
• Urology Care Foundation: Hypospadias

Common questions our doctors are asked

My son has mild hypospadias. Will he abound out of it?

Hypospadias will not right itself over time. Mild hypospadias may demand no correction, only other types will crave a surgical repair.

After surgery, will my son's penis look normal? Will intercourse exist a problem later in life?

Every effort is made past you child'south surgeon to make the penis wait and office normally. Intercourse is usually not afflicted in the long term, but each outcome is different. You can discuss this with your child's surgeon earlier and later on the performance.

Adult by The Imperial Children's Hospital Urology and Surgery departments. Nosotros admit the input of RCH consumers and carers.

Reviewed May 2018.

Kids Wellness Info is supported past The Majestic Children's Infirmary Foundation. To donate, visit www.rchfoundation.org.au.

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Source: https://www.rch.org.au/kidsinfo/fact_sheets/Hypospadias/

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