Hypospadias is a congenital defect of the male genitalia characterized by an ectopic location of urethral meatus on the ventral side of the penis, proximal to the tip of the glans. It is the second most common birth abnormality, occurring in approximately 1 in 200 newborns.
The severity of hypospadias can be classified according to the site of urethral opening:
i) distal hypoaspadias when the urinary opening is on or near the glans;
ii) midshaft hypoaspadias when the urinary opening is at the penile shaft;
iii) proximal hypoaspadias when the meatus is near the scrotum or perineum.
Hypospadias is also frequently associated with others genital malformations such as penile curvature which may impair sexual activity, undescended testis, underdeveloped “hooded” foreskin, penoscrotal transposition and pubic hypertrophy.
Boys born with hypospadias are generally diagnosed with the condition at the time of birth. Corrective surgery is often performed during the first two years of life. However, some boys born with hypospadias, are managed without surgical correction, and decide to have corrective surgery in adulthood. In other cases, surgery is attempted at early age but fails and the patients reach adulthood with the uncorrected malformation. Thus, hypospadias is a condition that can be seen in adult patients.
The aim of hypospadias repair is to place the urinary opening in the normal location, at the tip of the glans. Along with urethral reconstruction, also the penile curvature should be assessed and corrected at the time of surgery, as well as any penile skin deformities to provide a nice cosmetic appearance.
The choice of which surgical technique is best for repair is made on a case-by-case basis following established approaches.
