- The normal penis is formed by a straight shaft, that leads to the head, or the glans . At the tip of the glans, there is a slit like opening, called the urethral opening or meatus. The glans is completely covered by an extension of the shaft skin called the foreskin, or prepuce. In circumcised boys, the foreskin is removed, so that the head of the penis is always exposed. In others, during the first few years of life, the foreskin loosens up, and can be rolled back to expose the glans.
- Boys with hypospadias have a urethral opening is not at the tip, but on the undersurface of the penis.
- Besides this, the foreskin is not well formed and does not wrap around the penis completely, but ispresent only on the upper side, appearing like a hood. This is generally the most noticeable aspect of a mild hypospadias. The shaft , or the glans, may be bent towards the urinary opening, making it bow shaped rather than straight. This is called chordee. Chordee is more accentuated during an erection.
- Hypospadias can occur in varying degrees of severity. Most have a minor type, where the urinary opening is nearer the head of the penis – the so called distal hypospadias. Some have the opening lower down, making it a mid-shaft hypospadias. A proximal hypospadias is more severe, the opening being nearer the scrotum. Such boys will generally have a more curved penis, a scrotum which is higher on either side of the penis than otherwise and may have other problems with their urinary system or testicles, that may need attention.
