Hypospadias

Incidence: 1 in 150 per male births (among most common congenital anomalies in males)

Identified on exam
1. Undescended Testicle (10% association)
2. Inguinal Hernia
3. Hydrocele
4. Chordee (ventral penile curvature)
Identified on Ultrasound
1. Vesicoureteral Reflux
2. Ureteropelvic junction obstruction
3. Horseshoe Kidney (or pelvic Kidney)
4. Crossed renal ectopia
5. Renal agenisis

Avoid Circumcision (foreskin needed for repair)
Consult Pediatric urology
1. Initial Consultation at time of diagnosis
2. Referral at age 3 to 4 months
Surgical repair at 6 to 12 months of age
1. Distal Hypospadias (most common)
  1. Typically repaired in a single surgery (curvature repaired at same time)
  2. Urethral catheter is typically in place for 1 week following surgery
  3. Few complications
2. Proximal Hypospadias
  1. Evaluate for disorder of Sexual Development if Undescended Testicle also present
  2. Often requires 2 procedures for repair (esp. if severe curvature)
  3. Second surgery if needed is performed at 6 months
  4. Uses foreskin for repair graft (if second procedure needed)