Hypospadias

Hypospadias is a condition in infant boys in which the opening that carries urine out of the body (the urethra) is on the underside, rather than the tip, of the penis. It’s a congenital condition, or present at birth, and that’s when you or your child’s doctor may first notice it.

 
What are the signs and causes of hypospadias?

There are different degrees of hypospadias, with the urethral opening appearing anywhere along the length of the penile shaft. Most are mild or moderate and a small percentage are severe. Hypospadias may cause your child to have a deflected urine stream.

There may also be other penile abnormalities associated with hypospadias. For example, the skin that covers the urethra is often thin and poorly developed and can result in bending of the penis, causing it to curve. This curvature is called a chordee. Although hypospadias may run in families, there’s no single known cause of the condition.

 
How is hypospadias treated?

You might feel worried if your son is born with hypospadias, but you should know that it is a common condition. Nemours pediatric urologists are experienced at repairing the problem and restoring the appearance and function of your child’s penis.

Our Nemours urologists correct hypospadias with surgery that is usually performed when your son is older than 4 months of age. Depending on the severity of hypospadias, our doctor may perform straightening of the penis, relocation of the meatus (urethra opening) to the tip of the penis and the creation of a cosmetic glans (head of the penis) and penile shaft.

The goal of hypospadias repair is to normalize urination, create normal erections, and to improve the cosmetic appearance of the penis. The surgery is often same day surgery, and the overall results are excellent, with children going on to have normal urinary and sexual function in adulthood.

Urine Test: Dipstick

What It Is

A urine dipstick test is often done as part of an overall urinalysis, but it also can be done on its own, depending on the doctor's concerns.

Once a urine sample is collected, a nurse or technician will place a specially treated chemical strip (dipstick) into your child's urine (pee). Patches on the dipstick will change color to indicate the presence of such things as white blood cells, protein, or glucose.

Why It's Done

The results of a urine dipstick test may point to a diagnosis of urinary tract infection (UTI), kidney disease, diabetes, or a urinary tract injury. If test results are abnormal, other tests will be needed before a definite diagnosis can be made.

Preparation

No preparation other than cleansing the area around the urinary opening is required for the urine dipstick test.

The Procedure

Your child will be asked to urinate into a clean sample cup in the doctor's office. If your child isn't potty trained and can't urinate into a cup, a catheter (a narrow, soft tube) may need to be inserted into the bladder to obtain the urine specimen.

The skin surrounding the urinary opening has to be cleaned and rinsed just before the urine is collected. In this "clean-catch" method, you or your child cleans the skin around the urinary opening with a special towelette. The child then urinates, stops momentarily, and then urinates again into the collection container. Catching the urine in "midstream" is the goal. Be sure to wash your hands and your child's hands after this process.

Sometimes, if the doctor is concerned about a urinary problem that isn't due to an infection, a urine collection bag might be used to collect a sample from an infant. If you're doing the collection at home, you'll clean your baby's genital area and then arrange the bag around the urinary opening. Once the bag is in place, you'll secure it with the attached adhesive tape. You can put a diaper on your baby after you've attached the bag. You'll be instructed on how to remove the bag once your baby has urinated into it, usually within an hour.

Sometimes, if the doctor is concerned about a urinary problem that isn't due to an infection, a urine collection bag with adhesive tape on one end might be used to collect a sample from an infant. If you're doing the collection at home, you'll clean your baby's genital area and then arrange the bag around the urinary opening. Once the bag is in place, you'll secure it with the attached tape. You can put a diaper on your baby after you've attached the bag. You'll be instructed on how to remove the bag once your baby has urinated into it, usually within an hour.

Once collected, the technician or nurse will then place the dipstick into the urine sample. Collecting the specimen should only take a few minutes.

What to Expect

Because the test involves normal urination, there shouldn't be any discomfort as long as your child can provide a urine specimen. It's important to keep the area around the urinary opening clean before the test and to catch the urine sample midstream.

Getting the Results

The results of the urine dipstick test will be available right away. If abnormalities are found, further urine tests will be needed. Talk to your child's doctor about the meaning of the specific test results.

Risks

No risks are associated with taking a urine dipstick test. If a catheterized specimen is required, it may cause temporary discomfort.

Helping Your Child

The urine dipstick test is painless. Explaining how the test will be conducted, and why it's being done, can help ease your child's fear. Make sure your child understands that the urinary opening must be clean and the urine must be collected midstream.

If You Have Questions

If you have questions about the urine dipstick test, speak with your doctor.

Reviewed by: Yamini Durani, MD
Date reviewed: September 26, 2016