Penoscrotal Hypospadias Birth Defects

What is penoscrotal hypospadias?

Hypospadias refers to a urethral pee-hole which is located along the underside, rather than at the tip of the penis. Distal hypospadias pee-hole may be located on the underside of the penis, in the glans. For more serious hypospadias, the urethra may be open from mid-shaft out to the glans or the urethra may even be entirely absent, with the urine exiting the bladder behind the penis.

A male with hypospadias may have to urinate while sitting down, rather than standing up. He may also be prone to urinary tract infections. Our society does not look kindly on genital differences therefore causing male embarrassment.

What causes penoscrotal hypospadias?
Hypospadias occurs in about 1 in 125 infant males. In most cases, the cause of the hypospadias is not known. If the testes fail to produce adequate amounts of testosterone, virilization which is enlargement and development of the genital tubercle and scrotal swellings, will not be complete and hypospadias will result. Similarly, if the cells of the genital structures lack adequate androgen receptors, hypospadias will occur. If those cells lack the androgen converting enzyme, 5 alpha reductase, and inadequate androgen stimulation will follow and hypospadias will occur. (Source: David A. Hatch, MD.)

What is the treatment for penoscrotal hypospadias?
Here is when the recommendations get murky. Doctors will recommend surgery pre-puberty but there is little follow up as to its success. Male teens with sexual dysfunction are too embarrassed to discuss the problem.

One school of thought is that genital surgery performed on infants and children who are too young to understand the implications for their sexual future can be emotionally traumatic. The hidden message is that the child's genitals, although not causing him any physical discomfort, made adults so uncomfortable that they had to be surgically fixed before he was old enough to have a say in the matter.  And men who wait until adulthood fear surgery on their penis.

There are no simple solutions. Because of psychological reasons, the Intersex Society of North America recommends waiting to do surgery until a man or young adult can make his own decision. There are tradeoffs but who is in a better position to decide then the man himself.

Along with embarrassment and possible sexual dysfunction, will be urinary tract infections, pain and suffering, scarring, and painful erections.

Counseling to the family of a male child with penoscrotal hypospadias is a must. Because this condition is a congenital birth defect, there may be environmental causes or if the mother was taking any prescription or over-the-counter drugs during her first trimester of pregnancy. If your son was born with penoscrotal hypospadias, please consider contacting the Anapol Schwartz personal injury law firm to find out what your legal options are.