Hypospadias is the term used to describe an abnormality of the penis in which the opening (meatus) is not positioned and the end of the penis. It is noted in approximately 1 in every 150 male births. In these patients the opening can be located anywhere along the course of the urethra. In 90+% of cases the opening is located just off of the head of the penis (glans). In very minor variants, the opening will be located in a normal position, but the foreskin will not completely encircle the head of the penis. This variant is referred to as an incomplete prepuce, or sometimes a “natural circumcision”. In more severe variants the opening may be located were the penis meets the scrotum, or even behind the scrotum. It is often associated with a downward curve in the penis as well (chordee). Most patients with hypospadias are otherwise healthy males. Hypospadias is not dangerous to a child’s health. Surgical correction is recommended in those patients with an abnormally positioned opening not only for cosmetic purposes, but, in those patients in whom the opening is not located on the head of the penis, as these boys approach potty training, they will often be noted to have a sharply downward directed urine stream making directing their stream of urine difficult.
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