Hypospadias is a medical term for what is actually a congenital urethral anomaly in male children, with an incidence of about 3.3 per 1,000 (1 in 300). So how do we determine if a newborn male child has a congenital urethral anomaly? We can check for the presence of penis, normal urination and urinary exit hole in newborn boys, but at this time the child is small so the position of the urethral opening and the presence or absence of penile recurvature may be difficult to identify, and in severe cases of hypospadias, it may not even be possible to identify a male or female from the vulva at birth. In addition, newborn boys can be examined for other significant malformations, such as testicular descent into the scrotum, inguinal hernia, and anorectal malformation. As the child develops, especially after the age of 2 years, most boys can stand to urinate, and it can be found that the urine line does not come out from the front of the glans but from the body of the penis during urination, which often wet the clothes and pants, and in more serious cases, it is necessary to squat to urinate, and at this time, it is also easy to observe developmental deformities, such as cryptorchidism and inguinal hernia. When the child reaches the age of 5 or 6, the abnormal development of the penis becomes more obvious from the appearance, which can be seen in the abnormal distribution of the foreskin on the dorsal side of the penis, the downward curvature of the penis and the abnormal opening of the urethra. When a child goes to the hospital, a professional urologist will often look at the following three aspects to determine if hypospadias is present. The first is the abnormality of the urethral opening. The ectopic opening of the urethra is anywhere from the proximal end of the normal urethral opening to the perineum where the urethra travels, and the urinary position of the child may vary depending on the location of the urethral opening and the presence or absence of combined penile recurvature. Next, with or without penile recurvature, the penis is obviously bent ventrally, which may be caused by the incomplete development of the urethral corpus cavernosum and subcutaneous fascia tissue distal to the urethral orifice, replaced by fibrous tissue, and the lack of subcutaneous tissue on the ventral side of the urethra in the body of the penis resulting in asymmetry between the dorsal and ventral sides of the penile corpus cavernosum. Finally, the abnormal distribution of the penile foreskin, the absence of the ventral tether of the penis, and the cap-like accumulation of the foreskin on the dorsal side of the penile head. According to the position of the urethral orifice after artificial erection to confirm the absence of penile hypospadias or penile hypospadias correction, hypospadias can be divided into distal type (penile scrotum type, scrotal type, perineum type), middle type (posterior 2/3 penile stem type), and proximal type (penile head type, coronal groove type, and distal penile type). Hypospadias is a congenital malformation and treatment is necessary, otherwise it not only affects normal urination but can lead to inability to have a normal sexual life in adulthood. Successful treatment of hypospadias should achieve the following objectives: firstly, it is necessary to correct the downward curvature of the penis, to correct the bending deformity, to make the appearance of the penis satisfactory, the skin over the penis is soft and elastic, and the scar is not obvious; secondly, the urethral opening should be orthotropic, the diameter of the reconstructed urethra is appropriate, there is no curvature, the urethra is flat, there is no hair growth, and there is growth potential; finally, the appearance of the penis should be close to normal, the child can urinate standing up, the urinary line is thick, and the child can have normal sexual intercourse as an adult. The child should be able to urinate standing up, have a thick urinary line, and be able to have a normal sexual life as an adult with few complications. The components of hypospadias repair are hypospadias correction, urethroplasty, urethroplasty and glansoplasty, and phalloplasty (skin covering of the penis). The key to successful repair of hypospadias is the comprehensive knowledge of the surgeon in the repair of hypospadias, the selection of tissue with good blood supply for application, gentle minimally invasive operation techniques, and tension-free urethral reconstruction and anastomosis. Several factors should be taken into account when choosing the surgical procedure including the degree of penile recurvature, the position of the urethral opening, the presence of urethral stricture, the size of the penile head, the development of the distal urethra, and the quality of the skin covering the ventral side of the penis, rather than judging the severity of the condition simply by the distance of the urethral opening from the glans. Therefore, hypospadias is not terrible, and it can be completely cured with early and correct treatment.