Hypospadias is one of the most common malformative uropathy, accounting for 28% of them. Its frequency reaches 1 in 300 newborn boys and is extremely rare in girls. Hypospadias is a condition in which the meatus (opening) of the urethra is not in its usual place at the tip of the penis. It can be congenital or acquired. Congenital hypospadias is more common and is an embryonic defect whereby the external opening of the urethra does not open at the tip of the penis, but slightly more ventrally and proximally. The types of hypospadias are determined according to the location of the opening and are: Subcoronal – the opening of the urethra is located somewhere near the head of the penis, Midcorporeal – the opening is found somewhere along the length of the penis on its ventral side (lower) and Penoscrotal type – when the opening of the urethra is located at the junction of the penis with the scrotum. Acquired hypospadias is caused when circumcisions are performed by untrained and non-professionals in various religious communities (iatrogenic hypospadias). The literature indicates various factors that predispose to the development of congenital hypospadias. The most significant of them are genetic, endocrine, hereditary, intrauterine factors. It is assumed that the malformation occurs more often in children born with low weight, with the use of hormonal preparations – the role of progesterone preparations used during pregnancy in in vitro procedures is indicated. The age of the parents is also decisive – very young or very old. Pathogenetically, there is hypoplasia of the tissues forming the anterior urethra and the ventral side of the penis. The diagnosis is made immediately after birth by performing a thorough physical examination of the male reproductive system. In most cases, this defect is combined with varying degrees of curvature of the penis, as well as the absence of one or both testicles in the scrotal cavity. The combination of hypospadias and cryptorchidism is not rare and reaches up to 9% of cases. The treatment of hypospadias is entirely surgical, and there are many and varied techniques. The aim of the surgical intervention is both to correct the anatomical defect of the urethra and the penis as close as possible to normal, and to restore the functions of urination, erection and, subsequently, ejaculation. In mild forms of hypospadias, when there is no deviation (displacement) of the penis, the operation is only cosmetic. In more severe cases, it may be necessary to carry out a two-stage operation. With it, the first stage involves straightening the curvature of the penis by releasing it from the chords. In the second stage, a new urethra is formed. The rate of complications is directly related to the severity of the hypospadias, the method used and the experience of the operator. The most common complications observed are urethral fistulas – in 1/3 of the cases. They can appear in a different postoperative period – from several months to several years after the intervention.A stenosis of the meatus (opening of the urethra) may occur, which is manifested by a collection of urine behind the stenosis during urination, a ballooning is outlined. The treatment of this complication is dilatation of the meatus manually or by means of a catheter. Epispadias is a rarer malformation of the urethra in which the external meatus (opening) is located on the dorsal (upper) part of the penis proximal to the glans penis. It is usually combined with other genitourinary abnormalities, such as bladder exstrophy. Clinically, two types of epispadias are distinguished: complete, in which the sphincter of the bladder is usually affected and patients have urinary incontinence, and incomplete form. Diagnosis is made at birth by describing the location of epispadias, assessing the presence or absence of penile dorsal curvature and urinary incontinence. The treatment of this condition is operative, and the most suitable time for this is until the first year of the children. The operation consists in removing the curvature of the penis by removing any existing chordae and constructing a neourethra. The most common complications of surgical treatment are urinary incontinence and antegrade ejaculation as a result of insufficiency in the closing mechanism of the bladder neck. References: Urology – Prof. P. Panchev Centers for disease control and prevention – Facts about hypospadias