This is a congenital problem present in some newborn boys (occurring approximately
in 1:250 male births). This describes an abnormality whereby the opening is not at the
very end of the head of the penis. The opening from which the stream emanates may be
malpositioned on the bottom of the penis-anywhere from the head of the penis to the
scrotal area. There may also be an associated bend or curvature downward, called chordee.
The further removed the opening is from the end of the penis, the more likely that
a chordee be present. Circumcision should not be done in infants with hypospadias,
since the foreskin is often used in the requisite corrective surgery.
Surgical correction is best accomplished between six months to one year of
age via ambulatory surgery under general anesthesia. As noted above, the foreskin
may be used for creation of the new urinary channel and/or coverage of the bottom
surface of the penis when chordee is present. Post procedure, one can anticipate
both an excellent cosmetic and functional result.