Hypospadias is a congenital anomaly in which the structure of the urethra is changed. In patients with this disease, the urethra is shorter than usual, and it opens not where it should, but somewhere on the ventral surface (lower side) of the penis. This leads to various kinds of disorders affecting the processes of urination and ejaculation.
Short anatomical reference: the urethra in men is a canal of about 18 - 20 cm, originating from the bladder and serves to hold urine during urination and sperm during ejaculation. The urethra passes through the pelvic floor and penis. In the male body, normally, the urinary passage opens on the glans penis.
Classification of hypospadias
There are several forms of hypospadias that are classified according to the position of the opening of the urethra:
- anterior hypospadias (the least severe form, the opening is only slightly offset from the norm);
- average hypospadias (the opening of the urethra is located between the head and the subcoronary part of the penis);
- lower (the most severe form, this includes all types of hypospadias, in which the opening opens between the scrotum and perineum).
The most severe forms of hypospadias are often associated with other anatomical abnormalities of the penis and urinary tract. Among these anomalies, the so-called congenital curved penis is most often found. The problem is the excessive curvature of the penis, due to the slow growth of the ventral fascia of the penis. As a result, patients experience difficulties with erection: penis is bent down.
Causes of Hypospadias and Risk Factors
The exact causes of hypospadias are not known. Obviously, the hereditary factor matters. According to statistics, at least 20% of hypospadias cases are associated with a family history. Also, based on statistics, a number of risk factors were identified. They relate to the mother of the unborn child suffering from hypospadias. It includes:
- age over 40;
- exposure to chemicals (e.g. pesticides).
Symptoms of hypospadias
As mentioned above, hypospadias is a congenital disease. Nevertheless, it may go unnoticed in some newborns, especially if we are dealing with a mild form of the disease. A few years later, when the child begins to use the toilet, the first difficulties arise. The boy is forced to piss while sitting.
Upon completion of puberty, hypospadias significantly affects the patient's life, since it affects not only urination, but also the process of ejaculation. After the patient finds out about his illness, he may suffer from depression. The patient feels his inferiority and difficulties arising in everyday life lead to moral discomfort.
Diagnosis and therapy of hypospadias
The diagnosis of the disease is determined after a physical examination of the penis. The only way to treat hypospadias is surgery. The operation can be performed at any age, but it is recommended from 4 months to a year and a half, because the postoperative period is less traumatic for a young boy, compared with an adult man.
Most operations regarding hypospadias (about 90%) are successful and without complications in the future. However, there is a risk of urethral fistula or urethral stenosis. The prognosis for hypospadias is positive if you seek surgical help. Conversely, non-operated hypospadias in a negative way affects the life of a man.