Hypospadias is a congenital condition in which the opening of the urethra (the channel that carries urine and semen) is not located at the true tip of the penis. Instead, the opening forms on the underside of the shaft, near the scrotum, or occasionally in the perineum. This occurs due to an incomplete fusion of the urethral channel during early fetal development and is frequently accompanied by an incomplete foreskin layout and varying degrees of downward penile curvature (chordee).

Primary Symptoms

• Abnormal Meatal Location: The urinary opening is physically positioned anywhere along the underside of the penis rather than at the center of the glans.

• Downward Spraying: A diverted urinary stream that sprays downward or irregularly, often requiring sitting down to urinate.

• Altered Foreskin Appearance: The foreskin may look like a 'hood' covering only the top half of the penis, leaving the underside exposed.

• Associated Curvature: Concurrent downward bending of the penile shaft during an erection.

Diagnostic Approach

1. Anatomical Mapping: A thorough visual examination in the clinic to determine the precise location of the urethral opening and assess the quality of the surrounding tissue.

2. Functional Evaluation: Reviewing the strength and direction of the urinary stream to ensure there is no localized narrowing or stricture at the opening.

Recommended Surgical & Treatment Pathways

Dedicated Subspecialty Center: Genital Reconstruction Hub →

Surgical Reconstruction: Urethroplasty (EPA and Buccal Mucosa Graft) — Revisional urethroplasty for adult hypospadias cripples and persistent meatal stenosis.