Intended for healthcare professionals

Practice 10-Minute Consultation


BMJ 2020; 369 doi: (Published 17 June 2020) Cite this as: BMJ 2020;369:m2070
  1. Rosalind Jane Mole, general practice registrar,
  2. Stuart Nash, general practitioner,
  3. Duncan Neil MacKenzie, plastic surgery consultant
  1. Plymouth Hospitals NHS Trust, Plymouth, Devon, UK
  1. Correspondence to R Mole rosalindmole{at}

What you need to know

  • Hypospadias is a common congenital condition characterised by a ventral meatus

  • Hypospadias should be identified at the newborn baby check, but can be missed

  • Refer to a hypospadias surgeon when the abnormality is identified, to plan for surgery at 1 year

A 6 week old boy is brought into clinic. His parents are concerned about the way he passes urine. They say the opening of his penis is on the underside. He appears otherwise healthy.

Hypospadias is the most common congenital defect of the penis,1 and occurs in approximately one in 250 infant boys in Europe.2 It is characterised by a urethral meatus on the ventral aspect of the penis or scrotum, dorsal winged prepuce (foreskin), and ventral curvature of the penis (chordee). These features can be present in varying degrees of severity.

In this article we offer a guide for assessing hypospadias in primary care. As soon as a baby with hypospadias is identified, he should be referred to secondary care. This is often following a newborn baby check, before mother and baby are discharged from maternity …

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