Hypospadias is a condition where the urethral opening is not located at the tip of the penis. Since the urethra carries the urine from the bladder to the outside of the body, treating severe cases of hypospadias as soon as possible should be a priority. The good news is that hypospadias can be diagnosed while the baby is still in the mother’s womb, which helps in early treatment. Here’s what you need to know about the prenatal diagnosis of hypospadias and things that parents can expect for its treatment and management.
What is Hypospadias?
Hypospadias is a birth defect in boys where the urethral opening is not at the tip of the penis. This usually happens between the 8th and 14th week of pregnancy.
The location of the urethral opening can be anywhere from just below the tip of the penis to the scrotum. Based on the location, here are the types of hypospadias:
- Subcoronal – when the urethral opening is just near the tip of the penis
- Midshaft – when the urethral opening is somewhere along the shaft of the penis
- Penoscrotal – when the urethral opening is further down: at the point where the shaft of the penis meets the scrotum
If not treated, the child may have difficulty in urination, recurrent infection, abnormal appearance of the penis and impaired ejaculation
The good news is that early treatment is possible because hypospadias can be diagnosed while the baby is still in the womb.
Prenatal Diagnosis of Hypospadias
Doctors suspect hypospadias during pregnancy through ultrasound scans. In a study of 32 scans, 25 appear to have hypospadias, of which 18 have the condition confirmed after birth. However, routine ultrasound does not entail checking of such conditions, that is why a Congenital anomaly scan is advised at 24-28 weeks of gestation.
Doctors often suspect hypospadias when they see a “blunt tip” appearance of the penis. Normally, in scans, the penile tip is pointed. Other findings associated with hypospadias found in ultrasound scans are as follows:
- Ventral shortening and curvature of the penis. This usually represents chordee, a condition where the penis is bent when erected.
- Buried appearance of the penis, which means the penis is significantly shortened.
- Tulip sign, which usually signifies severe case of hypospadias. Tulip sign occurs when there is a transposition of the penosacral area and the penis is curved and found in between the scrotum fold.
- There is deflection in the baby’s urine stream inside the womb.
Pregnancy and Delivery Management
Should a doctor suspect hypospadias in your baby, what can you expect with regards to pregnancy and delivery management?
The first thing that a doctor may tell you is that the condition is often an isolated finding, meaning in most cases (greater than 80%), it doesn’t occur with another anomaly. Still, the possibility of an associated birth defect is possible.
The good news is that hypospadias don’t appear to affect pregnancy outcomes. Hence, the timing and manner of birth will continue to depend on usual obstetrics findings by the doctor.
Treatment After Birth
The most common treatment for hypospadias is surgery to correct the defect. In many cases, the baby will only need one surgery. However, some forms will require more than one operation.
Expect a couple of visits to the surgeon for postoperative assessment and care. Afterward, the child may need to regularly visit a urologist, particularly when it’s time for toilet training.
Key Takeaways
Hypospadias is a condition where the urethral opening is not at the tip of the penis. It can be diagnosed while the baby is still in the womb, through ultrasound scan. However, definitive diagnosis is not possible until after the baby’s birth. The good news is that it doesn’t appear to affect the pregnancy outcomes and often, one surgery is enough to address the condition.
Learn more about Pregnancy Problems here.
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