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Hypospadias

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The most important points

  • Hypospadias is a common malformation of the male genitalia in which the urethral opening is incorrectly positioned.
  • Typical signs are a deviating position of the urethral opening, curvature of the penis and atypically shaped foreskin.
  • The diagnosis is usually made in the puerperium, and further investigations are carried out for severe forms.
  • Depending on the severity, surgery is recommended to reconstruct the urethra, correct the curvature and correct the foreskin. A mild form does not always require surgery.
  • The hospital stay after the operation is under general anaesthetic. The urethra is splinted using a bladder catheter for a few days. The prognosis is generally good, with a complication rate of between 5-25%.

Clinical picture

What is hypospadias?

Hypospadias is a common malformation of the male genitalia and occurs in 1:300 newborns. The cause has not been clarified, a familial clustering occurs.

Symptoms

What are the typical signs of hypospadias?

Typical signs of hypospadias are a malformation of the urethral opening, with varying degrees of severity. The opening may be only slightly displaced in the area of the glans, in the area of the shaft or, in severe forms, also in the area of the scrotum. In addition, there is usually a curvature of the penile shaft of varying severity as well as an atypically shaped foreskin (foreskin apron).

Diagnosis

How is hypospadias diagnosed?

The malformation is usually already noticeable in the puerperium. In severe forms, especially if an undescended testicle is present at the same time, hormonal and possibly genetic investigations must be carried out. Occasionally, an ultrasound scan is performed to rule out other malformations in the kidneys and urinary tract.

Therapy

How can hypospadias be treated?

Depending on the severity of the hypospadias, an operation with reconstruction of the missing urethra (relocation of the opening to the tip of the penis), correction of the curvature and correction of the foreskin is recommended, as restrictions in function can occur later (incorrectly directed urine stream, erection problems, difficulties with procreation). The ideal time for this operation is between the ninth and eighteenth month of life. A mild form does not always require surgery.

Hospitalisation

What happens during my child's hospitalisation?

The operation is performed under general anaesthetic. During the operation, a bladder catheter is inserted to splint the newly formed urethra, which remains in place for between seven and fourteen days depending on the severity of the hypospadias. However, discharge with a catheter is possible after two to five days. Parents are instructed in the care and handling of the catheter beforehand.

Immobilisation or bed rest is not necessary after the operation and children can move around normally.

Forecast

What is the prognosis for hypospadias?

Overall, the clinical picture has a good long-term prognosis. You will be informed in detail about the risks and complications of the operation in the consultations before the operation. The complication rate is 5-25 % (depending on the severity of the hypospadias).

Literature

Further reading

  • PaediatricUrologyGuidelines 2022; European Association of Urology, C. Radmayr et al.

Responsible department

Who treats this clinical picture?

Counselling hotline for child and youth emergencies

The Medgate Kids Line provides quick and uncomplicated medical advice if your child is unwell. The medical team of our partner Medgate is available to you by telephone around the clock.

058 387 78 82
(billing via health insurance)

For emergencies abroad: Call the emergency number of your health insurance company. You will find this number on your health insurance card.

More information: On the Page of the emergency ward you will find everything you need to know about behaviour in emergencies, typical childhood illnesses and waiting times.

Important emergency numbers

144 Outpatient clinic
145 Tox Info Suisse (Poisonings)
117 Police
118 Fire brigade

UKBB

University Children's Hospital Basel
Spitalstrasse 33
4056 Basel | CH

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