In children or New Borns who have hypospadias, a congenital anomaly, the urethra's entrance is on the bottom of the penis rather than at the tip. The tube that allows urine to leave your body after leaving your bladder is the urethra. 

Hypospadias is frequent and has no negative effects on how you should care for your baby. Surgery typically returns your child's penis to its original look. Most males with hypospadias can have normal urination and reproduction with effective therapy.

Symptoms 

Instead of being near the apex of the penis, the urethra's entrance is found on the bottom in hypospadias. The urethra's entrance is often found inside the head of the penis. Less frequently, the entrance is located near the base or in the center of the penis. The hole rarely occurs in or beneath the scrotum. 

Hypospadias symptoms and signs can include: 

->  Opening of the urethra somewhere other than the penile tip 

->  The penis' downward curvature (chordee) 

->  The penis seems hooded because the foreskin only covers the top half of the penis. 

->  Excessive splashing while urinating Symptoms 

When to visit a doctor 

The majority of newborns with hypospadias are identified while still in the hospital, shortly after birth. The urethral opening may, however, be slightly displaced, which makes it more modest and challenging to detect. If you are worried about how your child's penis looks or if they are having issues urinating, speak to your doctor.

Causes 

At birth, hypospadias is present (congenital). A male fetus's foreskin and urethra form as the penis develops, in response to particular hormones. When these hormones fail to operate as intended, the urethra develops improperly, which results in hypospadias. 

The precise cause of hypospadias is typically unknown. Hypospadias can occasionally be inherited, but environmental factors may also be important.

Risk elements 

Although the exact cause of hypospadias is unknown, the following factors may be linked to the condition: 

->  Family history: Infants with a history of hypospadias are more likely to have this issue. 

->  Genetics: The hormones that encourage the development of the male genitals may be disrupted by specific gene mutations. 

->  Maternal age over 35: Some evidence indicates that infant males born to mothers over the age of 35 may be at an elevated risk of hypospadias. 

->  There is some hypothesis that a mother's exposure to certain hormones or certain compounds, such as pesticides or industrial toxins, during pregnancy may be linked to hypospadias, but more research is required to establish this. 

Complications 

Hypospadias can cause the following if it is not treated: 

->  An abnormal penis appearance 

->  Difficulties with potty training 

->  An abnormal penis curve during an erection 

->  Issues with ejaculation that is inhibited

Diagnosis 

Based on a physical examination, the pediatrician can identify hypospadias in your child. He or she will probably suggest that you seek additional assessment from a pediatric urologist, a surgeon who focuses on genital and urinary issues. Medical facilities with specialized teams can offer skilled therapy and assist you in weighing your options. 

It may be challenging to tell if the genitals are definitely male or female when the urethral opening is atypical and the testicles cannot be touched during examination (ambiguous genitalia). In this situation, a multidisciplinary team review is advised.

Treatment 

Some hypospadias cases are modest and might not necessitate surgery. To relocate the urethral opening and, if necessary, straighten the penile shaft, surgery is typically required as part of treatment. Between the ages of six and twelve months, surgery is typically performed. 

There should be no circumcision performed if the penis appears abnormal. The circumcision should be finished if hypospadias is discovered. Referral to a pediatric urologist is advised in both scenarios.

Surgery 

The majority of hypospadias types can be treated with a single outpatient procedure. For some types of hypospadias, more than one operation may be necessary to treat the problem. 

The surgeon may need to utilize tissue grafts from the foreskin or the inside of the mouth to reconstruct the urine channel in the correct place and treat hypospadias when the urethral opening is close to the base of the penis.

The outcome of surgery 

Surgery generally has a very high success rate. Boys often have normal urination and reproduction after surgery, and the penis usually looks normal. 

Rarely, a fistula (hole) forms along the bottom of the penis where the new urinary channel was made, causing urine to flow. There is rarely an issue with wound healing or scarring. These issues might need to be fixed by additional surgery. 

After-care 

Following surgery, your child will require a few appointments with the surgeon. After that, routine follow-up visits with your child's pediatric urologist are advised to check on healing and potential issues at puberty and after toilet training.

Getting ready for the appointment 

Most of the time, your child's hypospadias is identified while they are still in the hospital after birth. Most likely, a pediatric urologist will be recommended to you. To assist you in getting ready for your appointment, here is some information. 

What can you do? 

->  Ask a family member or friend to accompany you; a reliable travel companion can aid with memory retention and emotional support. 

->  Make a list of inquiries to make to your physician.

Questions to consider asking could be: 

• -> Do I need to have my child have surgery? 
• -> When is the ideal timing for surgery? 
• -> What are the dangers of this procedure? 
• -> What happens if my child refuses to undergo the procedure? 
• -> Will this disease have an impact on my child's sexual ability or fertility in the future? 
• -> What is the possibility that subsequent children may develop the same condition? 
• -> Can I get some brochures or other printed materials? 
• -> What websites would you suggest? 
• -> During the appointment, don't be afraid to inquire about anything else.

What to anticipate from your physician 

Be prepared to respond to inquiries from your child's doctor, including: 

• -> Has anyone else in your family received a hypospadias diagnosis? 
• -> When getting an erection, does your child's penis slope downward? 
• -> Have you ever seen your child spraying unusually when they urinate?

By Recmed Medical - Pediatric Urology Doctors (Click the link to connect with our Pediatric Urology Doctors)