Hypospadias is a common birth defect where the urethral opening in boys is located on the underside of the penis instead of the tip. It affects 1 in 150–300 male infants and is often associated with a downward bend (chordee).

The exact cause is unknown, but genetics may contribute. It is usually diagnosed at birth. If identified, circumcision should be avoided as the foreskin may be needed for surgical repair. Children should also be checked for undescended testes, which may require further evaluation.

Treatment involves surgery—ideally between 6–12 months of age—by an experienced pediatric urologist. The surgery corrects the bend and repositions the urethral opening. In more severe cases, multiple surgeries or testosterone therapy may be needed before repair. Post-operative care involves close monitoring of dressings and catheters. Long-term follow-up until puberty is essential, as issues like urine flow problems, stream deviation, or psychosexual concerns may develop. For adolescents or adults with complications, transitional urologists—experts in both pediatric and adult urology—should be consulted. At AINU, we are developing India’s first center of excellence for lifelong transitional urology care, ensuring comprehensive support from childhood to adulthood.

- Dr  P Ashwin Shekar, Consultant Pediatric & Transitional Urologist, AINU