Hypospadias and Penile Abnormalities

Some babies are born with penile abnormalities that can affect the shape or structure of the penis. If the function or appearance of the penis is not right, surgery to correct the problem can be considered.

Types of Penile Abnormalities in Babies

The most common penile abnormality is hypospadias. It affects about 1 in 300 - 350 boys. The opening of the penis is usually located at the top end of the penis, but in hypospadias it is positioned on the underside of the penis instead. It could be between the head (glans) and shaft of the penis, further along the shaft, or down near or below the scrotum.

Hypospadias is often associated with a bend (chordee) or twist (torque) of the penis, and a hooded foreskin, which means that the foreskin only covers the top side of the penis rather than going all the way around.

Megaprepuce is a type of buried penis characterized by extensive redundancy and ballooning of the inner prepuce as a result of a tight phimosis. It is usually asymptomatic but can cause discomfort and increase the risk of urinary infections.

Other penile abnormalities include a bend, twist or hooded foreskin without a hypospadias, penoscrotal tethering or a webbed penis. The latter occurs when skin from the scrotum extends over the shaft of the penis. Although this won't usually affect the function of the penis, it can have a big impact on its appearance.

Causes and Effects of Penile Abnormalities

The reasons why some boys are born with penile abnormalities are not fully understood; in a minority of cases it runs in families.

Some abnormalities won't have much of an effect on your child, but others could affect urination or future sexual activity. Penile abnormalities won't usually affect a boy's fertility. As long as the testes are healthy, he should still be able to produce sperm. However, a severe abnormality could affect sexual function in the future if it is not corrected.

Treatments for Penile Abnormalities

Treatment isn't always required for minor abnormalities in the structure of the penis that won't affect the function of the penis and it shouldn't have any impact on your child's ability to urinate or to have children in the future. However, a consultation with a specialist is recommended to discuss if surgery is required.

A procedure can ensure that your child is able to urinate while standing. Surgery can also correct problems that would affect erections in the future. You may also wish to consider surgery to help with cosmetic issues such as a webbed penis. Even if the function of the penis is not affected, a penile abnormality could have a big impact on a boy's self-confidence.

Surgery may also be recommended for some foreskin abnormalities that could cause problems, such as phimosis or megaprepuce.

If your child has a penile abnormality, then it is important to see a specialist for assessment. A paediatric urologist can help you to be fully informed about the impact of the condition and thereby help you decide whether treatment is needed to correct it.

Correction of hypospadias or other abnormalities is usually carried out as day-case procedure under general anaesthetic. More severe degrees of hypospadias may require a two-stage repair performed approximately 6 months apart. Surgery is usually recommended from 12 months of age.