What is Hypospadias?
Hypospadias is a congenital (since birth) abnormality of a boy’s penis. The urinary opening is not located at the tip of the penis. The foreskin is deficient on front side giving a hooded appearance. There may be forward curvature (chordee) of penis and scrotum may be encroaching around penis or may be divided (bifid).
The abnormal urinary opening (meatus) is located anywhere on shaft of penis, near scrotum or perineum.
How common is hypospadias?
Hypospadias is one of the most common anomalies found in boys (one in 200). In most cases it is the only abnormality. However, it may be associated with other abnormalities like undescended testis and may be a part of many anomalies (syndrome).
How is hypospadias diagnosed?
Clinical examination by the doctor confirms the diagnosis.
Sometimes, the doctor may advise some tests like sonography to rule out other abnormality.
What is the treatment of hypospadias?
Surgical correction (operation) of hypospadias is recommended before the child attends the school. Surgery should be performed when the child is one year old.
The aim of the surgery is to make the penis straight and bring the urinary meatus at the tip of the penis.
The surgery is performed under general anesthesia and lasts between one and three hours depending on the severity of the hypospadias. The surgeon uses the skin on the penis to create a new tube, which lengthens the urethra so that a new hole can be created at the tip of the penis.
Most cases are treated with one surgery. However, few of them require two surgeries (two stage repair) six months apart.
Surgery corrects the angle of the urine stream, allowing the child to urinate standing up in a normal way when he is older. It also allows pain free straight erections and improves the appearance.
Are there any risks or complications of the operation?
Little swelling and bruising of the delicate body part is expected and disappear with time. A small risk of infection is minimized with antibiotics. Excess bleeding during or after the operation is rare.
The original hole opens up again (fistula) in 10 to 20% of cases and the child may pass urine through two holes. This can happen at any time after the surgery and may require to be fixed after six months.
The new hole created at the tip or the tube created may become narrow (stenosis, stricture) and the urine stream becomes thin. It is corrected by dilatation of the opening or the urethra. Rarely, an operation is required to correct this. Hypospadias surgery in Ahmedabad, Gujarat
How to take care of the child after the operation?
Feeding can be started 3 to 4 hours after the surgery. The child will require to stay in the hospital for a day or two. Urinary catheter and the dressings will need to stay for 7 to 10 days.
The surgeon will explain how to take care of the dressing and urinary catheter at home. He will also explain the medicines to be given to the child.
You will need to come back to the hospital on the given date and time.
The dressing and urinary catheter will be removed. Some amount of swelling and bruising is expected on the penis and the child may feel some pain while passing urine. These things settle down within a few days.