Hypospadias and Epispadias Hypospadias and epispadias are congenital anomalies of the urethra, which involve abnormal positioning of the urethral opening. These conditions can impact urinary function and, in males, reproductive health. 1. Hypospadias: o Definition: Hypospadias is a condition where the urethral opening is located on the underside (ventral side) of the penis, rather than at the tip. o Types: The condition is classified based on the location of the abnormal opening:  Distal Hypospadias: The opening is near the head of the penis.  Midshaft Hypospadias: The opening is located along the shaft.  Proximal Hypospadias: The opening is at the base of the penis or near the scrotum. o Symptoms: Symptoms include a curved penis (chordee), abnormal urinary stream, and potential difficulties with urination. In severe cases, there may be associated issues with penile development. o Diagnosis: Diagnosis is often made at birth based on physical examination. Imaging studies are typically not required unless there are additional concerns. o Treatment: Surgical correction is usually performed between 6 and 18 months of age. The goal is to reposition the urethral opening and correct any associated curvature. Early intervention is crucial to ensure normal function and appearance. 2. Epispadias: o Definition: Epispadias is a condition where the urethral opening is located on the upper (dorsal) side of the penis in males or in the clitoris or anterior vaginal wall in females. o Types: Epispadias can occur in isolation or as part of a more complex condition: o  Penile Epispadias: The opening is located on the dorsal side of the penis.  Cloacal Epispadias: In females, the urethra opens into the clitoris or anterior vaginal wall. Symptoms: In males, symptoms include a dorsal opening of the urethra and abnormal urinary stream. In females, symptoms might include an abnormal opening of the urethra and difficulties with urinary control. o Diagnosis: Diagnosis is generally made through physical examination. Imaging studies may be used to assess the extent of the anomaly and associated abnormalities. o Treatment: Surgical intervention is often required to reposition the urethra and reconstruct the affected area. Surgery aims to improve urinary function, sexual function, and cosmetic appearance. Timing and specific techniques depend on the severity of the condition and associated complications. Management and Follow-Up:  Both conditions may require ongoing follow-up to monitor for complications such as urinary tract infections or issues with sexual function.  In cases where hypospadias or epispadias is part of a broader syndrome or involves significant anatomical abnormalities, multidisciplinary care involving urologists, surgeons, and endocrinologists may be necessary.