The Guide to Getting It On (123 page)

Some of the researchers who have done the most work with PGAD are Marcel Waldinger, Sandra Leiblum, David Goldmeier and DH Schweitzer.

CHAPTER

57

Hypospadias

H
ypospadias is a condition where the urethra (tube you pee through) doesn’t go to the end of the penis. In mild cases, it comes out near the end of the penis, but not quite. In more severe cases, it can come out anywhere from below the head of the penis to the scrotum.

Hypospadias is one of the most common birth anomalies there is, occurring in 1 in 125 to 500 boys. The possible reasons range from genetics and environmental pollutants called endocrine disrupters to diet. (An excellent study released in 2008 cites diet and obesity of the mother during pregnancy as risk factors, with a vegetarian diet or a diet lacking in meat and fish showing a strong positive association with hypospadias risk.)

It makes sense that cases of hypospadias occur on the bottom side of the penis where nature left a long seam. That’s because when the penis is forming in the womb, nature zips it up along this seam. The urethra goes inside the chamber of the penis that’s just inside the seam. With hypospadias, the urethra got caught in the zipper like your penis will if you are in a hurry and zip your pants up before your penis is safely out of harm’s way.

Hypospadias is usually a minor birth defect that often looms far more massively in the mind of the guy who’s got it than in mind of a potential partner. There is nothing about hypospadias that makes a man any less of a man or any less of a lover, although sometimes it results in a condition where the penis curves more than normal.

The real damage from hypospadias is usually the shame and aloneness that a man feels when he’s growing up. One of the reasons for feeling so different is because he’s often got to sit down to pee, given how the pee shoots out the side of his penis instead of the end. The guy knows he’s different from other males, and often lives in terror that others will find out and make fun of him. Of course, this never happens, given how kind, understanding and uncruel children are about others who are different...

Aside from feeling like he’s got this horrible secret in his pants, most men with hypospadias have a medical history where they had to have their penis repeatedly inspected and examined by this doctor and that. And not being able to leave well enough alone, surgeons are frequently called in to do what often turns out to be multiple surgeries. (While medical intervention is sometimes helpful in certain cases, there are plenty of guys who would have been far better off if their penis had been spared the surgeon’s knife.)

As is the case where any kid grows up feeling his body is defective, the most important issues to deal with are often the psychological. Men with hypospadias usually feel great emotional relief when they can meet and talk to other men who have the same condition. Fortunately, the Internet is making this much more possible than in times past.

Men with hypospadias sometimes grow up fascinated by other guys’ penises. This is perfectly logical when you consider how often their penis gets handled by parents and doctors, often without a helpful explanation. It also makes sense given how focused a guy with hypospadias can be about the way his penis is different from other penises. However, there is no evidence that hypospadias results in a different sexual orientation unless that’s what was going to happen from the start, hypospadias or not.

As for sex and relationships, the main difference between a penis with hypospadias and one without is where the cum shoots out, and that’s not going to make a bit of difference to most women. As one female reader said,

“I can name you hundreds of other things women are more concerned about in a man than if his pee or cum shoots out straight or from the side—most women wouldn’t give a rat’s ass. Only guys worry about things like that.”

Rest assured there’s no reason why you can’t become a father, so birth control is just as necessary for a man with hypospadias as for any other guy. The urethral opening for men with hypospadias is sometimes a little bigger, and some men with hypospadias are prone to urinary tract infections. So drinking extra water and peeing after sex might be a good habit to get into.

Men with hypospadias recommend that you tell a partner about your hypospadias sometime after you’ve gotten to know each other but before you’ve got your hands in each other’s pants. You can always pull out
The Guide
and point to this page if you need an ice breaker.

Epispadias

Epispadias is when the urethral opening opens on the top of the penis. The opening can be in one spot, or it can run the entire length of the penis. While it might seem that epispadias is simply a case of hypospadias turned on its ear, it is an entirely different anomaly than hypospadias. It is also very rare. Where approximately 1 in 125 to 500 boys has hypospadias, 1 in 117,000 boys are thought to have epispadias. While they aren’t sure what causes it, it is thought to result from a problem in the way the pubic bone develops.

Every once in a while, a girl will have epispadias, with it occurring in 1 in 478,000 girls. When it happens in females, the urethra will either exit higher than normal, between the clitoris and labia, or as high as the abdomen.

Resources:
If you have hypospadias, an excellent resource is the Hypospadias and Epispadias Association:
www.heainfo.org

CHAPTER

58

Birth Control — Sperm v. Egg

I
n the United States, 49% of pregnancies in women under the age of 34 are not planned or intended. The number rises to 75% for women over 40, and a whopping 80% of teen pregnancies are not wanted. Two-out-of-three unplanned teenage pregnancies happen to girls between the ages of 18 and 20.