Hypospadias

Hypospadias is a congenital displacement of the urethral opening onto the ventral surface of the penis rather than the tip. During approximately weeks 8–14 of gestation, the urethral folds should fuse as the external genitalia develop; incomplete fusion leaves the meatus ectopic. It occurs in approximately 1 in 200 live male births in Canada. The meatal position provides the first classification: - Distal: glanular or coronal - Midshaft: along the penile shaft - Proximal: penoscrotal or perineal Location is only part of the clinical picture. The nurse also looks for chordee, a ventral curvature that may become more apparent with erection, and a dorsally hooded foreskin, which reflects incomplete ventral development. Proximal disease is more likely to be associated with marked curvature and other genital abnormalities. The practical consequences depend on anatomy. A displaced meatus may alter the direction or force of the urinary stream, while chordee can affect penile straightness and later sexual function. The nursing assessment therefore asks more than “Where is the opening?” It asks whether the infant can void, whether the penis is significantly curved, whether...