Hypospadias: Symptoms, Concerns, and Sexual Health Impact

Suspected hypospadias

I am 25 years old.
Recently, my girlfriend noticed that sometimes my urine stream splits when I urinate.
I didn't pay much attention to it at first, but I recently read an article about hypospadias and realized that it seems somewhat similar.
Additionally, it seems that one of my testicles is positioned higher than the other and is not in the normal position.
To be honest, it’s not very noticeable unless you look closely.
Also, my penis appears to be slightly angled to the right.
Dr.
Chen, does this mean I have hypospadias? Will it affect my sexual activity?

Mr. Hsu, 20~29 year old female. Ask Date: 2002/07/02

Dr. Chen Xiuyi reply Urology

The causes of bifurcation in urination are not necessarily due to hypospadias; the most common reasons are urethritis leading to urinary tract narrowing or phimosis.
To determine if hypospadias is present, please consult a urologist for an examination.
The position of the testicles may not always be symmetrical even when they are in a normal position; conditions such as varicocele, hernias, or hydrocele can cause differences in testicular height.
The penis may deviate to the right during erection, which is generally caused by changes in the tunica albuginea of the corpora cavernosa.
When hypospadias causes penile deviation, it typically results in the glans pointing downward.
If the angle of deviation during erection is too pronounced, it may affect sexual intercourse and cause difficulties with penetration, in which case surgical intervention may be necessary.

Reply Date: 2002/07/02

More Info

Hypospadias is a congenital condition that affects the male urethra, where the urethral opening is not located at the tip of the penis but rather on the underside. This condition can vary in severity, with some cases presenting only minor cosmetic concerns, while others may have significant functional implications. Given your description of symptoms, including the bifurcation of urine flow and the positioning of your testicles and penis, it is understandable that you might be concerned about the possibility of hypospadias.

Symptoms and Concerns
The symptoms of hypospadias can include:
1. Abnormal Urethral Opening: As you mentioned, if your urine stream splits or diverges, this could be indicative of an abnormality in the urethral opening.

2. Penile Curvature: A penis that curves to one side, as you described, can be associated with hypospadias, particularly if it is accompanied by other symptoms.

3. Testicular Positioning: While the position of the testicles can vary, significant asymmetry or abnormal positioning may warrant further evaluation.

4. Difficulty with Urination: If you experience any pain, difficulty, or changes in urination, this should be addressed with a healthcare provider.

Impact on Sexual Health
Regarding your concerns about sexual health and function, hypospadias can have varying effects:
- Erectile Function: Most men with hypospadias can achieve normal erections and sexual function. However, depending on the severity of the condition, some may experience difficulties.

- Sexual Activity: Many individuals with hypospadias can engage in sexual activity without significant issues. However, if the condition is severe, it may lead to discomfort or complications during intercourse.

- Fertility: Generally, hypospadias does not affect fertility, but if there are associated anatomical abnormalities, it could potentially impact reproductive capabilities.

Next Steps
1. Consult a Urologist: It is crucial to consult a urologist who specializes in male reproductive health. They can conduct a thorough examination and determine whether you have hypospadias or another condition.

2. Diagnostic Tests: The urologist may recommend imaging studies or other diagnostic tests to assess the anatomy of your urethra and penis.

3. Treatment Options: If diagnosed with hypospadias, treatment options may include surgical correction, especially if the condition affects urination or sexual function. Surgery is typically most effective when performed in childhood, but adult cases can also be addressed.

4. Psychological Support: If you are experiencing anxiety or distress regarding your condition, consider speaking with a mental health professional. They can help you manage any psychological impacts related to body image or sexual health concerns.

Conclusion
In summary, while your symptoms may suggest a possibility of hypospadias, only a qualified healthcare provider can provide a definitive diagnosis. It is essential to seek medical advice to address your concerns and explore any necessary treatment options. Remember that many men with hypospadias lead normal, healthy sexual lives, and early intervention can often lead to positive outcomes.

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