Hypospadias

Hypospadias (pronounced hype-oh-spay-dee-us) is a birth defect

in boys where the opening of the urethra (the tube that carries
urine from the bladder to the outside of the body) is not located
at the tip of the penis.

What is Hypospadias?
Hypospadias is a birth defect in boys in which the opening of the
urethra is not located at the tip of the penis. In boys with
hypospadias, the urethra forms abnormally during weeks 8–14 of
pregnancy. The abnormal opening can form anywhere from just
below the end of the penis to the scrotum. There are different
degrees of hypospadias; some can be minor and some more
severe.

Types of Hypospadias
The type of hypospadias a boy has depends on the location of the
opening of the urethra:

 Subcoronal: The opening of the urethra is located

somewhere near the head of the penis.
 Midshaft: The opening of the urethra is located along the
shaft of the penis.
 Penoscrotal: The opening of the urethra is located where
the penis and scrotum meet.

Other Problems
Boys with hypospadias can sometimes have a curved penis. They
could have problems with abnormal spraying of urine and might
have to sit to urinate. In some boys with hypospadias, the testicle
has not fully descended into the scrotum. If hypospadias is not
treated it can lead to problems later in life, such as difficulty
performing sexual intercourse or difficulty urinating while
standing.

Occurrence
It is estimated that each year about 5 boys out of every 1,000
born in the United States have hypospadias, 12 making it one of the
most common birth defects.

Causes and Risk Factors

The causes of hypospadias in most infants are unknown. In most
cases, hypospadias is thought to be caused by a combination of
genes and other factors, such as things the mother comes in
contact with in her environment, or what the mother eats or
drinks, or certain medications she uses during pregnancy.
Just like the many families affected by birth defects, CDC wants
to find out what causes them. Understanding the risk factors that
are more common among babies with birth defects will help us
learn more about the causes. CDC funds the Centers for Birth
Defects Research and Prevention, which collaborate on large
studies such as the National Birth Defects Prevention
Study (NBDPS; births 1997-2011) and the Birth Defects Study to
Evaluate Pregnancy exposureS (BD-STEPS; began with births in
2014), to understand the causes of and risks for birth defects,
like hypospadias.

In recent years, CDC researchers have reported important

findings about some factors that affect the risk of having a baby
boy with hypospadias:

 Age and weight: Mothers who were age 35 years or older

and who were considered obese had a higher risk of having a
baby with hypospadias.3
 Fertility treatments: Women who used assisted reproductive
technology to help with pregnancy had a higher risk of having
a baby with hypospadias.4
 Certain hormones: Women who took certain hormones just
before or during pregnancy were shown to have a higher risk
of having a baby with hypospadias.5

CDC continues to study birth defects like hypospadias and how to

prevent them. If you are pregnant or thinking about becoming
pregnant, talk with your doctor about ways to increase your
chance of having a healthy baby.
Diagnosis
Hypospadias is usually diagnosed during a physical examination
after the baby is born.

Treatments
Treatment for hypospadias depends on the type of defect the boy
has. Most cases of hypospadias will need surgery to correct the
defect.

If surgery is needed, it is usually done when the boy is between

the ages of 3–18 months old. In some cases the surgery is done in
stages. Some of the repairs done during the surgery might
include placing the opening of the urethra in the right place,
correcting the curve in the penis, and repairing the skin around
the opening of the urethra. Because the doctor might need to use
the foreskin to make some of the repairs, a baby boy with
hypospadias should not be circumcised.

Other Resources
The views of this organization are its own and do not reflect the
official position of CDC.

 Hypospadias and Epispadias Association (HEA)

HEA offers support and education of people born with
hypospadias or epispadias and their families, loved ones, and
medical care givers.
References
1. Paulozzi LJ, Erickson JD, Jackson RJ. Hypospadias trends in
two US surveillance systems. Pediatrics 1997; 100:831–834.
2. Mai CT, Isenberg J, Langlois PH, Alverson CJ, Gilboa SM,
Rickard R, Canfield M, Anjohrin SB, Lupo PJ, Jackson DR,
Stallings EB, Scheuerle AE, Kirby RS for the National Birth
Defects Prevention Network. Brief report, Population-based
birth defects data in the United States, 2008 to 2012:
Presentation of state-specific data and descriptive brief on
variability of prevalence. Birth Def Res (Part A). 2015; 103:972-
994.
3. Carmichael SL, Shaw GM, Laurent C, Olney RS, Lammer EJ,
and the National Birth Defects Prevention Study. Maternal
reproductive and demographic characteristics as risk factors
for hypospadias. Paediatr Perinat Epidemiol. 2007; 21: 210–
218.
4. Reefhuis J, Honein MA, Schieve LA, Correa A, Hobbs CA,
Rasmussen SA, and the National Birth Defects Prevention
Study. Assisted reproductive technology and major structural
birth defects in the United States. Human Rep. 2009; 24:360–
366
5. Carmichael SL, Shaw GM, Laurent C, Croughan MS, Olney
RS, Lammer EJ. Maternal progestin intake and risk of
hypospadias. Arch Pediatr Adolesc Med. 2005;159: 957–962