Hypospadias is a birth defect of the male urethra. The opening of the urethra appears along the undersurface of the penis instead of the tip of the head of the penis. Boys with hypospadias may also have a downward curvature of the penis with erections (a condition called chordee) and a "hooded" foreskin, where the foreskin is present along the top of the penis but not along the bottom.
With distal hypospadias, the urinary opening is near the head of the penis, but it can be located further down in boys with proximal hypospadias, as far as within the scrotum. In addition to the abnormal appearance, the malpositioned urinary opening can result in difficulty aiming into the toilet with a spraying stream. In some boys the penis is bent downwards or sideways to an extent that sexual activity could be impaired as an adult – especially in those with more severe hypospadias and in boys with penile curvature (chordee) without hypospadias.
If hypospadias must be treated with surgery, the surgeon will likely straighten the penis (correcting chordee) and create an extension of the urethra, bringing it to the tip of the penis. Surgeons may use penile skin tissue to create the new urethral pathway for the urine.
When someone has hypospadias, it can make normal urination difficult – even if it's more of a cosmetic defect than a functional one. For example, some boys with hypospadias will not be able to stand to urinate because the opening of the urethra doesn't reach the tip of the penis. When boys have to sit to urinate, there may be social implications. Boys who can't stand to urinate may be teased by their peers.
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