Pediatrics
Hypospadias
Our surgeons have deep expertise and experience treating babies whose urethral opening is on the underside of their penis.
Medically reviewed by Albert Lee, D.O. on April 14, 2026.
What Is Hypospadias?
Hypospadias occurs when the opening for the urethra (the tube that carries urine out of the body) is on the underside of your baby’s penis instead of the tip. The condition affects where pee leaves your baby’s body, but it isn’t painful.
We know that any type of infant surgery is concerning. Your child is in the expert care of our highly skilled pediatric urology specialists. Our surgical team has a lot of experience in treating hypospadias in children.
On this page
Types of Hypospadias
The urethral opening (called the meatus) may form anywhere from the tip of the penis to the scrotum (pouch that holds the testicles). Types of hyposapdias depend on the location of the opening:
- Distal hypospadias: The opening is near the head of the penis.
- Midshaft hypospadias: The opening is towards the middle of the penis shaft.
- Penoscrotal hypospadias: The opening is at the base of the penis where it meets the scrotum or behind the scrotum.
Children with hypospadias may have other conditions, such as a curved penis (chordee). These conditions can cause problems with erections, ejaculation and sexual intercourse later in life if left untreated. Mild cases of distal hypospadias may not need treatment.
Symptoms of Hypospadias
Hypospadias is noticeable at birth. In addition to the urethral opening being in the wrong location, your baby may have other symptoms.
Common Symptoms
Other signs of hypospadias include:
- Incompletely formed foreskin that gives the penis a hooded look
- Pee that comes out in a spray instead of a stream
- Pee that sprays downward or to the side
- Penis that curves downward when erect (chordee)
- Undescended testicles
Hypospadias Causes and Risk Factors
Hypospadias is a congenital abnormality (birth defect) that occurs while a baby forms in the womb. The condition is present at birth. Medical experts are still trying to determine the cause.
Exposure to Chemicals
Exposure to certain chemicals or pesticides during pregnancy may increase risk. This includes smoking and exposure to secondhand smoking during pregnancy.
Family History
Hypospadias can affect male members of the same family, which may suggest a genetic link.
Other Risk Factors
Any baby boy can have hypospadias. However, pregnant women who have obesity, are older than 30, take hormones (progestin) or use certain treatments for infertility have a slightly higher risk of having a baby with hypospadias.
Diagnosis and Testing for Hypospadias
Health care providers check for signs of hypospadias soon after a baby’s birth. In some cases, the provider may discover the condition during preparation for circumcision, if your baby is having one. If that happens, the surgeon will stop the circumcision. This is so the foreskin can be saved and used in later surgery to correct the hypospadias. Your baby may get tests to check for other conditions and help their provider plan surgery.
Physical Exam
During a physical exam, your child’s doctor might measure the length of the penis, size of the penis head and degree of penile curvature.
Imaging Tests
Certain diagnostic and medical imaging tests, such as a pelvic ultrasound, can check for other problems and aid surgical planning.
Genetic Testing
Your child’s provider may recommend genetic testing if your baby has severe hypospadias and undescended testicles. A genetic test can check for a group of conditions called differences of sex development that affects how genitals form.
Hypospadias Treatments
Surgery typically takes place after your child is 6 months old. Your baby receives general anesthesia and sleeps through the outpatient procedure. Surgery may take up to three hours. Your baby goes home with you on the same day. Children who also have a curved penis may need more than one surgery.
Foreskin or Tissue Removal
The surgeon removes the foreskin to use for reconstructing the urethra. In some cases, they may also need to take tissue from another part of your child’s body.
Urethral Reconstruction
The surgeon uses the removed tissue to create a tube.
Penile Straightening
To straighten a curved penis, the surgeon may place stitches underneath the skin on the upper side of the penis. In severe cases, a child may need a graft on the underside of the penis. In severe cases, this might require more than one surgery.
About
1 in 150Boys have hypospadias
Distal hypospadias are most common, with
8 in 10Boys with hypospadias having this type
Sources: Centers for Disease Control and Prevention: Hypospadias
Urology Care Foundation: Hypospadias
Request an Appointment
As Sacramento's No. 1 hospital, you'll benefit from unique advantages in primary care and specialty care. This includes prevention, diagnosis and treatment options from experts in 150 specialties.
Referring Physicians
To refer a patient, submit an electronic referral form or call.
Patients
Call to make an appointment.
Consumer Resource Center
Awards and Recognitions
Ranked among the nation’s best hospitals
A U.S. News & World Report best hospital in cardiology, heart & vascular surgery, diabetes & endocrinology, ENT, geriatrics, neurology & neurosurgery, and pulmonology & lung surgery.
Ranked among the nation’s best children’s hospitals
U.S. News & World Report ranked UC Davis Children’s Hospital among the best in pediatric nephrology, orthopedics*, and pulmonology & lung surgery. (*Together with Shriners Children’s Northern California)
Ranked Sacramento’s #1 hospital
Ranked Sacramento’s #1 hospital by U.S. News, and high-performing in aortic valve surgery, back surgery (spinal fusion), COPD, colon cancer surgery, diabetes, gynecological cancer surgery, heart arrhythmia, heart failure, kidney failure, leukemia, lymphoma & myeloma, lung cancer surgery, pacemaker implantation, pneumonia, prostate cancer surgery, stroke, TAVR, cancer, orthopedics, gastroenterology & GI surgery, and urology.
The nation’s highest nursing honor
UC Davis Medical Center has received Magnet® recognition, the nation’s highest honor for nursing excellence.
World-class cancer care
One of ~59 U.S. cancer centers designated “comprehensive” by the National Cancer Institute.
A leader in health care equality
For the 13th consecutive year, UC Davis Medical Center has been recognized as an LGBTQ+ Healthcare Equality Leader by the educational arm of America’s largest civil rights organization.
Latest Children's Health News
