Hypospadias

Definition - What does Hypospadias mean?

Hypospadias is an abnormality of the male urethra from birth where the tube that urine passes from the bladder to the urethral meatus is positioned at an abnormal location on the underside of the penis or the scrotum. This can lead to impairment of the flow of semen that is typically ejected into the deep vagina during vaginal intercourse, potentially causing male factor infertility.

Hypospadias can also be associated with undescended testes and abnormalities in the size and shape of the penis (eg; small or curved penis) that can interfere with sexual function.

FertilitySmarts explains Hypospadias

Hypospadias is not uncommon. It affects around 1 in every 250 males and is the second most common congenital (from birth) abnormality of the male reproductive system.

Hypospadias can affect fertility in a male due to several factors

  1. During ejaculation, sperm is typically ejected forwards into the deep vagina. When the urethral meatus is not in the normal position, sperm may be deposited in the lower vagina or perineum making the journey the sperm have to take to swim towards the egg longer and, as a result, less successful.
  2. Undescended testes are commonly associated with hypospadias. Testes are the most important male sex organs that are responsible for production of sex hormones and sperm. Both testes need to be in the scrotal sac for them to function normally. Undescended testes can impair the normal reproductive function by reducing sex hormone levels and the quality and quantity of sperm.
  3. Hypospadias can also be associated with chordee. Chordee is the term used to describe a penis that is abnormally curved upwards of downwards closer to the head of the penis. The curvature generally becomes greater with an erection. Intercourse can be difficult or painful with this condition.
  4. The overall length and size of the penis, both at a flaccid state and when erect is usually smaller in patients with hypospadias. That also can impair sexual activity.

Surgery is effective in correcting the defect and is usually done during the first year of life. If done correctly and early in life, patients born with hypospadias can have a normal adulthood in terms of sexual function and fertility.

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