A man wearing a suit and tie smiling.

Dr. Nicolas Fernandez, pediatric urologist at Seattle Children’s

Hypospadias (pronounced hype-oh-spay-dee-us) is a birth defect where the opening of the urethra, the tube that carries urine from the bladder to the outside of the body, is not located at the tip of the penis. Depending on the severity of the condition, it can affect the penile function and one’s self-perception. It is a common condition that can be treated with surgery in some cases; however, a decision to proceed with surgery needs to be carefully thought through and discussed among the provider, parents and patients.

The current standard treatment for hypospadias starts with the provider defining the severity of the condition. The severity is based on the location of the urethral meatus, the external opening of the urethra, and the penile curvature. Based on the severity,  some patients may be offered surgery as a next step. Surgery involves using local tissue from one part of the patient’s body to relocate the urethral opening to the correct position at the tip of the penis. To date, assessment of the tissue is subjective, and therefore, it is hard for surgeons to repeat the process moving forward.

Dr. Nicolas Fernandez, a pediatric urologist at Seattle Children’s and surgeon scientist at the University of Washington, is working on a research project that aims to reduce this subjectivity and explore new approaches to better assess structural and genetic components of the tissue used for surgery. He is doing so by proposing a novel approach to evaluate hypospadias.

By using technology to detect small genetic differences that can lead to big changes in an individual’s physical characteristics and by applying artificial intelligence on patients with hypospadias, providers can improve clustering of individuals with similar characteristics to ensure a more accurate prediction for treatment and surgery for this condition. This ultimately leads to better, more impactful outcomes for the patient and family.

Dr. Fernandez spoke with On the Pulse about his research.

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