Hypospadias natural history, complications and prognosis

First degree hypospadias are primarily a cosmetic defect and have little effect on function except for direction of the urinary stream. If uncorrected, a second or third degree hypospadias can make male urination messy, necessitate that it be performed sitting, impair delivery of semen into the vagina (possibly creating problems with fertility), or interfere with erections.

If hypospadias is untreated, a boy may have difficulty with toilet training and problems with sexual intercourse in adulthood. Urethral strictures and fistulas may form throughout the boy’s life, requiring surgery.

Results after surgery are typically good. In some cases, more surgery is needed to correct fistulas or a return of the abnormal penis curve.

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