Urology
Quality and Outcomes

About Hypospadias

Hypospadias is a congenital condition, one that is present at birth, where the opening for the urethra or tube that carries urine and sperm is not located at the tip of the penis. The external urethral opening can be located anywhere along the underside of the penis from the tip to the rectum. In many cases, a condition called chordee, or downward curve of the penis, is associated with hypospadias.

Types of Hypospadias

Distal: external opening is located near the head of the penis (glanular or sub-coronal). This is the most common form of hypospadias.
Midshaft: opening is located along the middle shaft of the penis.
Proximal: opening is located near or at the base of the scrotum (penoscrotal, scrotal, or perineal). This type is considered more severe than others.

Treatment of Hypospadias

Texas Children’s Urology Division provides care for more than 500 patients who have hypospadias and performs over 190 hypospadias surgeries yearly. Many types of hypospadias can be repaired with a single outpatient surgery. Complex and severe cases may require more than one surgery. Surgical repair of hypospadias is usually done after 6 months of age.

The Goals of Hypospadias Repair are:

To bring the external urethral opening to the tip of the penis.
To straighten the penis if curvature is present.
To improve the appearance of the penis.

Hypospadias Volumes

Surgical Outcomes of Distal & Proximal Hypospadias

Our pediatric board-certified urologists are committed to provide the highest value of care to our patients. We continuously strive for successful outcomes of a normal appearing and functioning penis; however, there are occurrences where patients with hypospadias developed complications after their initial repair and required additional surgeries. Patients with severe type of hypospadias are at greater risk of developing complications. The most common complications of hypospadias repair is fistula, where urine leaks out of a second hole. Additional complications may include, but are not limited to excessive bleeding, poor wound healing, recurrent downward curve of the penis, diverticulum, meatal stenosis, skin tract, and or retracted meatus.

Hypospadias complications may not manifest until years after the initial repair. By tracking outcomes, we learn about what happens to our patients and we also learn about our performance as a health care delivery organization. At Texas Children’s Urology Division, we report our hypospadias complications to U.S. News & World Report Best Children’s Hospitals. The mission of U.S. News & World Report Best Children’s Hospitals is to identify hospitals that provide the highest quality of care for children with the most serious or complicated medical conditions. U.S. News & World Report Best Children’s Hospitals empowers parents and patients to make better, more informed decision about where to seek care.