The term hypospadias comes from the Greek terms hypo meaning “under” and spadon meaning “a tear”.
Hypospadias is considered a common “birth defect” that occurs in males where the hole through which urine and semen leave the body (the urethral meatus) is not located at the tip of the head of the penis. Instead, the opening is found on the underside of the head of the penis (the glans) or on the underside of the shaft of the penis. The opening can even be located well down the shaft, right in front of the scrotum; or between the testicles and the anus.
There are several other anatomical variations that often occur in men and boys with hypospadias. These include:
- An incomplete foreskin which is attached to the head or the sides of the penis but does not completely surround the head of the penis. This is often called a “dorsal hood”.
- A mushroom or helmet shaped head of the penis (the glans) rather than a cone-shaped one. This variation is quite common with hypospadias.
- A downward tilt of the penis head and shaft known as “chordee”.
Although there has been little or no research about how many men with hypospadias experience sexual difficulties of one kind or another, one might expect that the emotional consequences of hypospadias would produce a higher frequency of sexual dysfunctions like premature ejaculation, delayed ejaculation, and erectile dysfunction than in the wider population.
For example, it’s possible that men whose penis is “different” from the “norm” are more likely to experience anxiety around sex, or possibly anger and frustration about their sense of difference.
Having worked with men who have sexual dysfunctions for many years, my impression is that premature ejaculation is primarily linked to anxiety around sex, with a smaller proportion of cases being caused by anger, shame and guilt.
Bearing in mind that hypospadias tends to generate anxiety about exposure of the penis in general and to a sexual partner in particular, and in many cases produces a sense of shame about a man’s perceived “lack of masculinity”, it’s not unlikely that that men with hypospadias would experience a higher level of premature ejaculation than other men.
As for erectile dysfunction, in so far as it’s caused by anxiety around sex, the same logic may well apply: that men with hypospadias may well experience more erectile dysfunction than other men in the wider population.
Men who have the different penis associated with hypospadias are often extremely involved with their own sense of masculinity, searching constantly for a reference point that will allow them to understand how they compare with other men.