A man born with a debilitating genital condition has spoken candidly about the 'mental anguish' of believing he was alone in living with the condition – despite it affecting around 15 million men worldwide.

Social media influencer Joel M is raising awareness of hypospadias, a condition that affects the size, shape and functioning of the penis and affects around one in 300 men.

Yet, as the campaigner says, 'no one speaks about it'.

Hypospadias is the term for when the opening of the urethra – through which urine leaves the body – is located somewhere other than the tip of the penis.

Depending on the severity of the defect, the opening can be found just below where it should be, or anywhere along the underside of the penis.

In some cases it can extend as far down as the scrotum, leaving the penis extremely small and misshapen.

Patients suffer difficulty urinating, sexual dysfunction, fertility problems and chronic urinary tract infections.

Strictly Come Dancing star Brendan Cole has also previously spoken of his struggles with the condition.

Joel, who documents life with the condition including multiple surgeries he's endured to treat complications, says stigma prevents more men from seeking medical and emotional support.

In a video caption posted to his Instagram account, Joel, who had his first operation at 18-months-old, wrote: 'I was born with severe [hypospadias], a birth defect that impacts the penis where the urethra is not correctly or fully formed.

'Growing up, and even into my adulthood, I thought I was the only person in the world who bore the physical and (larger) mental anguish going through my hypospadias complications.

'Yet 1 in every 300 [boys are] born with hypospadias, meaning there's around 15 million boys and men directly impacted by it.

'And yet because it involves the penis, no one speaks about it. As far as we can tell [i'm] one of the only people ever to share my story with lifelong hypospadias complications on social media.'

Experts say the exact cause of hypospadias remains unknown, although genetics are thought to play a part.

What is hypospadias?

With hypospadias, the urethra - through which urine is expelled - emerges somewhere on the shaft or even the base of the penis, instead of at the tip. 

Sometimes the head of penis is tipped backwards, making it impossible to urinate standing. 

The condition (pronounced as hi-poe-SPAY-dee-usis) is also linked with undescended testes, so sometimes the man is infertile.

About 1 in 300 boys are born with some degree of hypospadias and those affected by it always have smaller-than-average penises.  

It is not known what causes it, although sometimes it runs in families. 

Many affected men never know they have a recognised condition and their parents never seek help, so doctors have been prevented from tracing inheritance patterns.

According to the Mayo Clinic, the condition is more common in children with a family history of hypospadias, while some research has suggested an increased risk among babies born to mothers over the age of 35.

Exposure to certain chemicals or pesticides during pregnancy may contribute, according to some studies, although further research is needed.

Corrective surgery for hypospadias is typically performed between 12 and 18 months of age and aims to reconstruct the urethra and reposition its opening.

While many boys require only one operation, those with more severe forms of the condition – like Joel – may need multiple procedures throughout their lifetime.

Joel's procedures have included a complex urethral reconstruction - surgery sometimes known as urethroplasty in which a damaged urethra is repaired.

He has also shared images of his suprapubic catheter – a tube inserted through the lower abdomen into the bladder to drain urine when normal urination is not possible.

Hypospadias can also affect sex life, particularly if the condition has not been fully corrected.

In some cases, it can reduce a man's ability to ejaculate.

Famous faces who have discussed living with hypospadias include former Strictly Come Dancing star Brendan Cole (left) and American Rapper Lil Dicky (right)

Joel has been open about how the condition has affected his sexual function, admitting that as a teenager he didn't know if he would be able to have sex 'properly'.

However, he has since married his wife and, writing in April, said: 'Sex matters - but it's not the only thing that matters.'

In another post he described finding intimacy through massages, dancing, listening to music and spending time outdoors together.

He has also highlighted that fertility treatment remains an option for many men with hypospadias, with techniques such as IVF helping couples conceive.

Speaking in 2018, Strictly star Brendan Cole, who also appeared on the 2022 series of Dancing on Ice, said he grew up feeling 'very self-conscious' due to the condition.

He told ITV's Loose Women: 'It's ingrained from you from an early age, have you got a small one or a big one. Most people have a fairly normal sized penis.

'I had issues when I was born called hypospadias. That also made me very self-conscious. It's where your penis isn't fully developed or has an issue.

'That was a major thing for me. I had 12 operations from the age of two to 12.'

Joel's condition also led to urethral stricture disease, in which scar tissue narrows the urethra and restricts the flow of urine.

Symptoms can include a weak urinary stream, painful urination and urinary tract infections.

Since beginning to share his story, Joel says he has connected with hundreds of others facing similar experiences.

He added: 'Through dialogue and support, we have been able to help [a lot] in our community, but we have a long way to go.

'In the modern world, the best way to raise awareness is through reach via social media.

'I'd be grateful if you could follow my page and share this with anyone you know who might be directly impacted by hypospadias or who might find my content interesting.'