- Affects approximately 1 in 500 boys
- Due to incomplete fusion of genital folds and glandular urethra
- Urethra found on ventral surface of penis
- Replaced distally fibrous chordee
- Deformity consists of malpositioned meatus, chordee and abnormal foreskin
- If any degree of hypospadias is present circumcision is contraindicated
- 70% are glandular or coronal
- 10% are penile
- 20% are scrotal
- Perineal hypospadias is associated with intersex and anorectal anomalies
Management
- Treatment is required
- To improve urinary stream
- To allow sexual intercourse
- Usually performed between 2 and 4 years of age
- Glandular hypospadias requires a glandular meatotomy
- Coronal hypospadias requires a meatal advancement and glanduloplasty (MAGPI operation)
- Proximal hypospadias without a chordee can be treated by a skin flap advancement
- If chordee present it should be excised and an island flap urethroplasty performed
Complications
- Complications of hypospadias surgery include:
- Urethral fistula
- Urethral stricture
Bibliography
Soomro N A, Neal D E. Treatment of hypospadias: an update of current practice. Hosp Med 1998; 59: 553-556.
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