How do we Know our Child has Hypospadias?

This is a very common doubt expressed by parents. Hypospadias is an external defect, hence it is very easy to observe and diagnose. Today most deliveries are attended by the pediatric doctor who examines the child at birth and usually picks up the abnormality.

However, the following points about a child’s penis can be observed by the parents to suspect hypospadias:

1. Abnormal penile appearance: Most (99%) cases of hypospadias have only half of the foreskin (the projection of skin from the tip of the penis). This gives a ‘hooded’ appearance to the penis which is easily made out by keen observation.
2. Abnormal shape of the penis: In many cases, hypospadias penis has a downward bend, called chordee, which can be easily seen by simple observation. It must be remembered that in some children, chordee can exist without hypospadias also
3. Abnormal location of urinary opening: The main definition of hypospadias is the abnormal location of the urinary opening on the undersurface of the penis. This is usually apparent when the penis is lifted up and the undersurface is examined. In most cases, the opening is below the normal position, but a groove or pit may be present at the tip of the penis giving the false appearance of a normal opening, or sometimes it looks as if there are two urinary openings.
4. In some cases of hypospadias, the penis is small in size, and the scrotum may also be abnormal and small. These observations should also alert the parents towards the possibility of the abnormality.
   In general, the penis is small at birth, so the structural details of the type and severity of hypospadias may not be clearly understood. Generally, by 6 months of age, the penis grows to a reasonable size (due to natural hormones), so in most cases, that is the best time to assess the severity and the type of hypospadias.

Dear parents, if your child has hypospadias, there is no need to panic. In the hands of experts, the abnormality can be corrected with excellent results, even in severe cases.