The door of the male department came bursts of baby cries, anxious parents holding the child into my clinic. “Dr. Wang, my child’s peeing is not normal, squatting is backward, you quickly look at it!” I signaled the parents to put down the child, and as I examined him, I asked, “How old is the child?” “13 months.” I found that this little boy’s urethral opening was low and his penis was curved, “Your child has congenital hypospadias.” “What is hypospadias?” The child’s mother asked, puzzled. Tell the child’s parents: hypospadias is a more common congenital malformation, manifested by the external urethral orifice being positioned lower than normal, and can be located anywhere between the coronal groove of the penis and the perineum. It is often accompanied by other malformations of the external genitalia such as ventral curvature of the penis, dorsal turban-like buildup of the foreskin, and cryptorchidism. “Why do we get hypospadias in kids that young?” The development of the penis and urethra is currently considered a “fragile” process that requires correct genetic programming, hormonal actions (mainly testosterone and its 5α reduction product: dihydrotestosterone), timely cellular differentiation and complex inter-tissue interactions. A malfunction in any of these areas can result in a poorly developed urethral sponge on the ventral side of the penis, resulting in a urethral opening that is ectopic anywhere from the coronal sulcus to the perineum, i.e., hypospadias. Hypospadias may occur as a result of inadequate androgen synthesis, androgen insensitivity, and exogenous antiandrogen-like effects, either alone or in combination. However, the molecular mechanisms underlying the occurrence and development of hypospadias have not been elucidated yet. According to the 2010 European Urological Association Guidelines for pediatric urology, the possible risk factors for hypospadias are A clear etiology of endocrine disorders may be found in very few cases. 2. mothers who give birth too early or too late and low birth weight of the newborn are a high risk factor for urethral hypospadias. 3. The incidence of hypospadias has increased markedly in the last 20 years, suggesting that environmental factors have an important influence on the development of hypospadias (hormone disruptors, pesticides, etc.). However, a history of oral contraceptive use before pregnancy does not increase the incidence of hypospadias in the offspring. “How can a child be cured of this condition?” The treatment of hypospadias relies primarily on surgery, both phase I and phase II treatments. Generally speaking, one-stage hypospadias correction surgery can be performed for patients with good localized penile skin conditions, penile curvature that can be corrected at the same time, and urethral defects that are not particularly long. One-stage surgery is less painful and quicker recovery for patients, which is the mainstream direction of hypospadias treatment at present. However, for patients with perineal type, penoscrotal type, poor local penile skin conditions or long defects after penile straightening, staged surgery also has its relative indications. Depending on the different tissue repair materials used, they are divided into local penoscrotal tipped flaps and free grafts (e.g., oral mucosa and bladder mucosa, etc.) repairs. In the end, I made a specific surgical plan according to the patient’s degree of penile curvature and the local penile skin and urethral external orifice varied, and successfully completed the hypospadias surgery. Three months after the surgery, the child’s parents wrote me a letter of thanks, and the child was able to stand upright to urinate!