Causes and risk factors
The exact cause of hypospadias is not known. Research is still going on in this field; however certain risks factors have been put forth. Pregnancies occurring at an elder age and in obese women, women who have undergone certain hormonal therapy prior to pregnancy or who have been conceived using certain reproductive technology, such babies are at higher risk for developing hypospadias.
Clinical presentation:
Normally the penis is covered by foreskin which is retracted back to expose the head of the penis, this development is completed until puberty. However in hypospadias the foreskin of the penis is not retracted back, the urethral opening is seen at the underside of the penis as a result the child faces difficulty in passing urine, the flow is not in a straight stream. Depending upon the urethral opening hypospadias is divided into three types-Sub coronal (the urethral opening is near the head of the penis), midshaft (urethral opening is at the shaft of penis) and penoscrotol (urethral opening is the junction of the penis and scrotum). In some of the cases abnormality in the shape of the penis is seen. It becomes curved. The person has to pass urine while sitting and such children are more prone for urinary infection.
Investigations:
Diagnosis is done of the basis of the symptoms narrated by the parents and the local examination carried out by the doctor. There is no specific diagnostic test for hypospadias.
Treatment:
No medications are available, surgical intervention is the only choice of treatment. Surgical repositioning of the urethral opening is done in stages. Surgery is best recommended at an early age.
Facts and figures:
Hypospadias is one of the common congenital defects seen. Incidence is seen in 4 out of every 1000 boys.
