Hypospadias may involve an abnormal urethral opening and urinary issues. At Liv Hospital, risk factors are evaluated for early pediatric care.
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Hypospadias Symptoms and Risk Factors
Visible Anatomical Indicators
The symptoms of hypospadias are primarily structural and are almost always identified at birth. The most prominent sign is the ectopic (misplaced) location of the urethral meatus. Instead of being at the tip of the glans, the opening may be located anywhere from just below the head of the penis to the perineum (the area between the scrotum and the anus). This displacement is often accompanied by a “hooded” appearance of the penis, where the foreskin is absent on the underside but redundant on the top. At Liv Hospital, our pediatric urologists carefully grade these symptoms to determine the complexity of the required reconstruction.
Chordee and Penile Curvature
A significant symptom associated with hypospadias is chordee, which refers to a downward bend or curvature of the penis. This is caused by a shortening of the skin on the underside or by fibrous bands of tissue that act like a bowstring. While chordee may be subtle in a relaxed state, it becomes more pronounced during an erection. If left untreated, severe curvature can make sexual intercourse difficult or painful in adulthood and can interfere with the proper development of the penile shaft during puberty.
Urinary Stream Abnormalities
Due to the abnormal positioning of the urethral opening, the urinary stream is often misdirected. Children with hypospadias may experience “spraying” or a stream that points downward rather than forward. As the child grows and begins toilet training, this can make it impossible to urinate while standing without causing significant mess. This functional symptom is often the primary motivation for parents seeking surgical intervention, as it impacts the child’s daily life and social integration as they enter school age.
Associated Genitourinary Conditions
Hypospadias can sometimes occur in conjunction with other developmental issues. Approximately 10% of boys with hypospadias also have undescended testes (cryptorchidism), where one or both testicles have not moved into the scrotum. In more severe, proximal cases, there may also be an increased risk of inguinal hernias. When these symptoms appear together, the specialists at Liv Hospital perform a more comprehensive screening to ensure that all aspects of the child’s genitourinary health are addressed during the treatment planning phase.
Genetic and Familial Risk Factors
Research indicates a strong genetic component in the development of hypospadias. If a father has the condition, there is an increased statistical likelihood that his son will also be born with it. Similarly, having an older brother with hypospadias raises the risk for subsequent male siblings. While specific gene mutations have been identified in a small percentage of cases, most are considered “multifactorial,” meaning they result from a combination of shared family genetics and common environmental exposures.
Hormonal Disruptions During Gestation
The formation of the male urethra is an androgen-dependent process. Any disruption in the production of testosterone or the conversion of testosterone to dihydrotestosterone (DHT) in the fetus can lead to hypospadias. This can be caused by the fetus’s inability to produce enough hormones or a reduced sensitivity of the tissues to those hormones. Hormonal imbalances in the mother, or the use of progesterone-based medications during early pregnancy, are also studied as potential contributing risk factors for the incomplete fusion of the urethral folds.
Maternal and Environmental Influences
Several maternal factors have been linked to a higher incidence of hypospadias. These include advanced maternal age (over 35), pre-existing maternal diabetes, and obesity. Environmental exposure to “endocrine disruptors”—chemicals found in some pesticides, plastics, and industrial products—is a significant area of research in 2026. These chemicals can mimic or block natural hormones, potentially interfering with the delicate window of urethral development between the 8th and 14th weeks of pregnancy.
Assisted Reproductive Technologies (ART)
There is a documented correlation between the use of assisted reproductive technologies, such as in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI), and an increased risk of hypospadias. While the absolute risk remains low, the increased prevalence in this population is thought to be related to either the underlying subfertility of the parents or the hormonal treatments used to support the pregnancy. At Liv Hospital, we provide specialized neonatal screening for infants born via ART to ensure early identification of any developmental variations.
Comprehensive Risk Assessment and Counseling
We believe that knowledge is the best tool for parents. At Liv Hospital, we provide detailed prenatal and postnatal counseling for families at risk. If hypospadias is suspected during a late-term ultrasound or identified at birth, our specialists meet with the family to discuss the degree of the condition and the expected outcomes. We focus on transparency and education, ensuring that you understand the biological factors involved. By choosing Liv Hospital, you are ensuring that your child’s care is guided by the most advanced clinical understanding of hypospadias symptoms and risks.
How Is Hypospadias Diagnosed and Evaluated at Liv Hospital?
At Liv Hospital, we understand that noticing these symptoms in your newborn can be distressing. Our pediatric urology team is dedicated to providing a clear, empathetic explanation of why these symptoms occurred and what can be done. We utilize a multidisciplinary approach, involving geneticists and endocrinologists when necessary, to provide a complete picture of your child’s health. Our facility is designed to support families through every step of the process, from the first diaper change in the nursery to the successful completion of surgical repair.
Send us all your questions or requests, and our expert team will assist you.
While no specific food causes hypospadias, maternal diet plays a role in overall placental health and fetal development. Diets lacking in essential nutrients or high in processed foods may contribute to metabolic conditions like gestational diabetes or obesity, which are risk factors. Furthermore, consuming food contaminated with pesticides or endocrine-disrupting chemicals (often found in non-organic produce or plastic packaging) may increase the risk by interfering with hormonal signaling.
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