In boys, the opening through which urine passes (the meatus) is located at the tip of the penis. A condition known as hypospadias is a birth defect that leaves the opening on the underside of the penis. There also may be an abnormal bending of the penis called chordee, which may cause sexual problems in adulthood. The meatus (the opening where urine passes) may direct the urinary stream downward and cause the stream to spray. A concern of many parents is the abnormal appearance of the penis in severe hypospadias, which can be a source of embarrassment to boys as they grow older.
After detecting hypospadias in your newborn, your pediatrician probably will advise against circumcision until after consultation with a pediatric urologist or surgeon. This is because circumcision makes future surgical repair more difficult. Mild hypospadias may require no treatment, but moderate or severe forms require surgical repair. At this time, most children with hypospadias undergo outpatient surgery at around six months of age. In severe cases, more than one operation may be needed to repair the condition completely. After surgery your child’s penis will appear nearly normal and he’ll be able to urinate normally and—when he’s older—have sexual relations.