MEDICAL DICTIONARY
Penis, hypospadias of the: birth defect of the penis involving the urethra (the transport tube leading from the bladder to discharge urine outside the body). The urethra in the male normally travels through the full length of the penis so that the stream of urine comes from the usual urethral opening at the tip of the penis. However, in hypospadias the urethra does not go all the way through the penis but, instead, opens prematurely on the underside of the shaft of the penis or below the penis.
Hypospadias can occur as an isolated birth defect, the only one in the child, or it can be just one component in a complex syndrome of multiple congenital malformations. It has been reported that hypospadias is more common in the sons of older mothers. However, this needs to be confirmed and a possible effect of advanced maternal age needs to be distinguished from that of advanced paternal age. (With older fathers, the risk of new mutations increases for a number of birth defects.)
In the slightest ("first-degree") sort of hypospadias, the urethral opening is below the tip but still nearby (on what is called the glans ). In moderate ("second-degree") hypospadias, the urethra opens closer to the body on the underside of the shaft of the penis. In severe ("third-degree") hypospadias, the urethal opening is below the penis on the skin and this is called a perineal hypospadias.
In a child with hypospadias, the urine comes from an opening that is on the underside of the penis or below the penis. With moderate-to-severe degrees of hypospadias, the boy will therefore usually sit to urinate. Some cases of first-degree hypospadias are so mild as to not require treatment.
If the hypospadias needs to be repaired, this is done by surgery. The aim is to repair and reconstruct the urethra. Depending on the degree of the hypospadias, the surgery can range from relatively simple to very challenging.
The opposite of hypospadias is epispadias , a less common birth defect in which the urethra opens prematurely on the upperside of the penis or above it.
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