Pathophysiology
Clinical meaning
Hypospadias results from incomplete fusion of the urethral folds during weeks 8-14 of embryonic development, when androgens (primarily dihydrotestosterone) direct masculinization of the external genitalia. Inadequate androgen signaling or receptor dysfunction leads to an ectopic urethral meatus on the ventral surface of the penis. The defect is classified by meatal location: glanular/coronal (anterior, ~50%), penile shaft (middle, ~30%), or penoscrotal/perineal (posterior, ~20%). Associated abnormalities include chordee and a dorsally hooded foreskin. The nurse manages perioperative care, monitors for surgical complications including urethral fistula and meatal stenosis, coordinates pain management, and provides comprehensive family education.