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: Creatinine

What It Is

Creatinine is a waste product that the muscles produce at a steady rate as part of normal daily activity. The bloodstream carries creatinine to the kidneys, which filter it out of the blood, and it is passed out of the body in urine.

A urine creatinine test measures the amount of creatinine in the urine. It can be done on its own or with other tests that determine the relative amounts of other substances being excreted in the urine.

Why It's Done

Healthy kidneys filter the blood to rid it of waste products that the body can't use. Low levels of creatinine in the urine may point to a kidney disease, certain muscular and neuromuscular disorders, or an obstruction of the urinary tract. If test results are abnormal, other tests will be done to make a specific diagnosis.

A creatinine clearance test measures the blood creatinine level as well as how much creatinine is being passed in the urine over several hours. This gives doctors information about how well the kidneys are functioning.

A doctor may order a urine creatinine test in combination with other urine tests even when no kidney dysfunction is suspected. Because creatinine is filtered out at a fairly steady rate, doctors compare the creatinine level with levels of other substances in the urine to determine if they're being excreted at a normal rate.

Preparation

Your child might need to temporarily stop taking certain drugs that affect the urine's creatinine levels and might be asked to not eat large quantities of meat in the day or two before the test.

The Procedure

Collecting the specimen should only take a few minutes. 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 small catheter may need to be inserted into the bladder to obtain the urine specimen.

If you collect the specimen at home, follow any storage and transportation instructions the lab gives you.

For a creatinine clearance test, you'll need to collect all the urine your child passes over a period of several hours (usually 24 hours). This usually involves first getting a special container from the lab in which to collect the urine, plus specific instructions about how to collect and store the timed urine sample.

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.

Getting the Results

In general, the results of the urine creatinine test are available within a day or two. Your doctor will go over the results with you and explain what they mean. If abnormalities are found, further tests may be needed.

Risks

No risks are associated with taking a urine creatinine test.

Infants may occasionally experience skin irritation from the adhesive tape on the collection bag. If a catheter is used to obtain the urine, it may cause temporary discomfort. If you have any questions or concerns about this procedure, talk to your doctor.

Helping Your Child

Collecting the specimen for a urine creatinine test is usually painless. Explaining how the test will be conducted and why it's being done can help ease any fear. Make sure your child understands that there should be no foreign matter, such as toilet paper or hair, in the sample.

If You Have Questions

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

Reviewed by: Yamini Durani, MD
Date reviewed: February 2012