Everything you wanted to know about hypospadias but were too afraid to Google By Jonathan Wells
Hypospadias. If it doesn't affect you, then it's likely you've never heard of the condition.
But for some men, it is a problem that has defined their entire lives. Last week, Mr Steve Baker - a pseudonym - candidly spoke to The Daily Mail about hypospadias, and how the genital malformation has concerned and confused him since childhood.
"It was a huge relief to learn I wasn't the only man affected," Baker stated in the interview. "I wish someone had told me what was wrong with me because my life could have been very different."
But what is hypospadias? Other than knowing it affects the penis, you'd be forgiven for having little or no idea how the condition presents or manifests itself. So, here's the definitive guide - everything you wanted to know about hypospadias (but were too afraid to Google).
depressed
What is it?Hypospadias is a congenital problem affecting a man's penis. Despite being termed as one condition, the problem actually presents in three separate ways.
- The hole through which urine passes - the meatus - is not situated at the tip of the penis as is normal. Instead, the meatus may present at the side of the head, along the penis or at the base near to the scrotum. Despite this malformation, the penis can usually still urinate in the same way.
Due to incomplete development of the penis, the foreskin tends to gather at the back of the penis. This may either look like a hood or give the illusion of circumcision.
Even when fully erect, the penis may still be bent or slightly curved - which may affect sexual activity. This bend is usually downwards.
How many people suffer from it?Paediatric Urologist Warren Snodgrass believes that, on average, 1 in every 300 boys born has some form of hypospadias. However, Matthew Jackson - a hypospadias specialist and researcher - tells Telegraph Men that "studies point to an increasing incidence that may be as high as 1 in 125-150 new born boys. We do not yet know exactly why we are seeing a rise in cases, but hypospadias is undoubtedly getting more common."
Urinals
How does it affect day-to-day life?Hypospadias can be diagnosed early on in life and, if caught, there is a surgical procedure that can correct the problem. However, there are an unfortunate few - such as Steve Baker - who go undiagnosed and have to live with the condition for their entire lives.
In these instances, there are several ways that hypospadias affects daily activities. Firstly, urination is much harder depending on the location of the meatus. Many men have to sit down to urinate because of the location of their meatus, and this can limit toilet usage. Urinals, for instance, are impossible for some sufferers to use.
Secondly, sexual activity can be uncomfortable. Given the bend in the penis and the undeveloped foreskin, engaging in sexual intercourse may cause pain for both parties and is therefore avoided by many adult sufferers.
Matthew Jackson explains: "Because the hole that is normally at the end of the penis is located somewhere on the underside of the shaft semen doesn’t come out in the same direction. The penis can be shorter than normal and curved which can cause mechanical problems with penetration in more severe cases.
"However, some men with hypospadias have no difficulties with sex," Jackson continues. "But the nature of the condition, that is often concealed for fear of embarrassment, means that it is difficult to know exactly how many men are troubled by it and how many aren’t."
What causes it?
Whilst there is no official known cause of hypospadias, there are a number of factors that are thought to exacerbate the chances of developing it in the womb. The penis begins to develop after the eighth week of pregnancy, with the defect in the urethra occurring between the ninth and twelfth weeks.
If mothers are obese, there is a higher chance of their sons being born with a malformed penis. Similarly, if the mother is over 35-years old, has conceived through in vitro fertilisation (IVF) or has taken hormone supplements during her pregnancy, the chances also rise.
Although not a hereditary condition, reports show that there is a 20 per cent chance of another close family member also having hypospadias if you do.
"Surgical correction can be undertaken in early childhood by paediatric urologists or in later life by adult urologists," says Jackson. "It is a benign condition that is not life threatening condition and men with hypospadias may be happy with their penis the way it is and choose not to have any treatment.
"The basic surgical aim of the operation is to return the penis back to the ‘normal’ anatomical appearance by making it straighter and moving the hole from the underside of the shaft back to the tip of the glans. There are lots of different ways surgeons can do this by reconfiguring the tissues of the penis and urethra using incisions and stitches, and occasionally grafts."
There are also preventative steps that the mother can take to ensure her child is never born with a malformation in the first place. These measures include not smoking when pregnant, taking folic acid supplements throughout the pregnancy (around 400 to 800 micrograms each day) and maintaining a health weight and lifestyle.
Does it make me more susceptible to other conditions?Not necessarily, but other conditions may present as a result of the factors that led to the hypospadias. Inguinal hernias - when fatty tissue or a part of your bowel, such as the intestine, pokes through into your groin at the top of your inner thigh - and undescended testicles are common examples of this.
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