Hypospadias

Hypospadias is a congenital difference in penile development caused by incomplete fusion of the urethral plate and ventral foreskin. The urethral opening therefore lies on the underside of the penis rather than at the glans tip. Ventral curvature, called chordee, may accompany the displaced meatus because the ventral tissues have not developed symmetrically. An experienced clinician looks beyond the opening itself. The foreskin may form a dorsal hood, the glans may be shallow or divided, and the shaft may curve when assessed by the pediatric urologist. The location of the meatus, degree of curvature, penile size, tissue quality, and position of both testes together determine the clinical complexity and surgical plan. An isolated distal defect is generally identified during the newborn examination and is not, by itself, an indication for emergency surgery. The priorities are to confirm that the infant can void, document the anatomy accurately, protect tissue needed for repair, and identify findings that suggest a broader disorder of sex development.