Hypospadias

Hypospadias is a congenital difference in penile development caused by incomplete fusion of the urethral plate and ventral foreskin during embryogenesis. The urethral meatus therefore opens on the underside of the penis rather than at the tip. Its position may range from the glans or subcoronal area to the midshaft, penoscrotal region, or perineum. The meatal location helps classify severity: - Distal: glanular or subcoronal - Midshaft - Proximal: penoscrotal or perineal Location is not the only feature that matters. Ventral curvature, called chordee, can interfere with a straight urinary stream and later sexual function. The foreskin may be incomplete ventrally, leaving a dorsal hood. That appearance is a useful bedside clue. An infant with hypospadias should not be circumcised routinely. The foreskin may provide tissue for urethral reconstruction, and removing it can limit the surgeon’s options. The newborn should be referred for pediatric urologic assessment instead.