This congenital malformation of the urethra which occurs once in every 350 males, is found in various parts of the urethra and presents certain difficulties in obtaining a successful closure. Many of these patients are first seen as infants, and treatment is usually deferred until the child is 4 or 5 years of age. The urethral canal terminates at a site on the under surface of the penis rather than in its normal position at the tip of the glans. The urethra distal to the false opening is usually absent. The glandular portion having a separate origin is observed as a groove varying in size and depth.
The types of hypospadias are usually classified according to the position of the false meatus.
A. Balanic hypospadias.
Approximately 70 to 75 per cent of the cases are of this type. The urethral opening is below its normal location in the glans, usually at the point where the frenum is attached. Surgical intervention is rarely necessary unless the meatus is pin-point in size and requires dilation or a meatotomy.
B. Penile hypospadias.
In this instance the meatus may be observed on the under surface of the penile urethra at any point between the glans and the penoscrotal junction.
C. Perineal hypospadias.
This rarest type is noted 3 or 4 cm. from the anus and is represented as a small slit in the groove which separates the scrotum into two parts. Perineal hypospadias must be differentiated from pseudohermaphrodism which it closely resembles.