Successful treatment of hypospadias

Symptoms

In hypospadias, the opening of the urethra is located on the underside of the penis instead of at the tip. In most cases, the opening of the…

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Causes

As with many other birth defects, doctors aren’t sure why some boys get hypospadias. They think some of the reasons could be…

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Precautions

You can reduce your baby’s chances of hypospadias while you’re pregnant.You can reduce your baby’s chances of hypospadias while you’re pregnant…

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Treatment

You can reduce your baby’s chances of hypospadias while you’re pregnant. Surgery is the only treatment available to correct hypospadias…

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About Hypospadias

Hypospadias (hi-poe-SPAY-dee-us) is a birth defect (congenital condition) in which the opening of the urethra is on the underside of the penis instead of at the tip. The urethra is the tube through which urine drains from your bladder and exits your body. Hypospadias is common and doesn’t cause difficulty in caring for your infant. Surgery usually restores the normal appearance of your child’s penis. With successful treatment of hypospadias, most males can have normal urination and reproduction.

 
 
 

Symptoms

In hypospadias, the opening of the urethra is located on the underside of the penis instead of at the tip. In most cases, the opening of the urethra is within the head of the penis. Less often, the opening is at the middle or the base of the penis. Rarely, the opening is in or beneath the scrotum.

  • Opening of the urethra at a location other than the tip of the penis
  • Downward curve of the penis (chordee)
  • Hooded appearance of the penis because only the top half of the penis is covered by foreskin
  •  Abnormal spraying during urination

 
 

Causes

As with many other birth defects, doctors aren’t sure why some boys get hypospadias. They think some of the reasons could be:

  • Genetics: It’s more likely if the boy has a father or brother who were born with it. It is also associated with some genetic syndromes.
  •  Fertility treatments:The mother may have used hormone therapy or medicine to help her get pregnant
  • The mother’s age and weight:There’s more chance a baby will be born with hypospadia if his mom is overweight and over age 35, has diabetes prior to her pregnancy.
  • Expsoure to smoking or pesticides
  • Premature

 
 
 

PRECAUTIONS

You can reduce your baby’s chances of hypospadias while you’re pregnant.

•Don’t smoke or drink alcohol.
•Don’t do Circumcision of the child with hypospadias.
Visit your doctor.
•Keep a healthy weight.
•Take 400 to 800 micrograms (mcg) of folic acid per day.
 
 
 

Treatment

You can reduce your baby’s chances of hypospadias while you’re pregnant. Surgery is the only treatment available to correct hypospadias. We recommend that these operations be performed between 6 and 15 months of age, when the psychological effects of genital surgery are minimal. At UCSF Benioff Children’s Hospital, hypospadias repair is done exclusively on an outpatient basis, minimizing separation of the child from parents and reducing the cost of the procedure.

Often, repair can be achieved in a single one- to three-hour operation at UCSF’s outpatient surgery center. The goal of surgical correction is to reconstruct a straight penis with a urethral opening as close to the tip of the penis as possible. This will result in a properly directed urinary stream, straightened penis upon erection and an appearance similar to a circumcised penis. The surgery is performed under general anesthesia and often your child will be admitted and discharged from the hospital on the same day.You can reduce your baby’s chances of hypospadias while you’re pregnant. Surgery is the only treatment available to correct hypospadias. We recommend that these operations be performed between 6 and 15 months of age, when the psychological effects of genital surgery are minimal.

At UCSF Benioff Children’s Hospital, hypospadias repair is done exclusively on an outpatient basis, minimizing separation of the child from parents and reducing the cost of the procedure. Often, repair can be achieved in a single one- to three-hour operation at UCSF’s outpatient surgery center. The goal of surgical correction is to reconstruct a straight penis with a urethral opening as close to the tip of the penis as possible. This will result in a properly directed urinary stream, straightened penis upon erection and an appearance similar to a circumcised penis. The surgery is performed under general anesthesia and often your child will be admitted and discharged from the hospital on the same day.

 
 
 

Our Doctors

Dr Obaidullah Obaid
M.B.B.S , fCPS(pLASTIC SURGERY)

Hypospadias Specialist

Mr. Junaid Ashraf
M.B.B.S. FEAPU, CPSP, FRCS(Paeds SURGERY)

Fellowship in Hypospadias

 
 

Frequently Asked Questions

Is hypospadias passed through genes?

In about 7 out of 100 children with hypospadias, the father also had it. The chance that a second son will be born with hypospadias is about 12 out of 100. If both father and brother have hypospadias, the risk in a second boy increases to 21 out of 100.

Is it necessary to fix distal hypospadias?

Many parents ask if surgery is needed for mild forms of hypospadias. It’s hard to predict problems a baby will have later in life. But there are many reasons for recommending correction, no matter how severe the condition.

  • As many as 15 out of 100 boys with hypospadias will have a penis that curves downward. When the curve is severe, when the boy is an adult it can interfere with getting an effective erection.
  • While the meatus may be in a nearly normal place, it’s often deformed. Some holes are larger while others are too small. Many have a web of skin just beyond the opening. These abnormalities can affect the urine stream. Some boys will notice urine spraying to the sides or downward. Many find they need to sit to void. Voiding can cause discomfort and irritate nearby tissues. The penis works, but these problems can be embarrassing.
  • A partly formed foreskin that isn’t fixed will always appear abnormal. This can call attention to the problem. Studies of boys with uncorrected hypospadias suggest lower self-esteem.

Most pediatric urologists today suggest fixing all but the most minor forms of hypospadias. In most cases, the benefits of correction far outweigh its risks.

What kind of anesthesia is used? Is it safe to put infants to sleep?

Hypospadias repair is done while the patient is asleep, under general anesthesia. Many anesthesiologists or surgeons also use nerve blocks near the penis or in the back to reduce discomfort when the child wakes up after surgery. These forms of anesthesia are very safe, especially when given by anesthesiologists who specialize in the care of children. Today, it’s thought safe to do surgeries such as hypospadias repair in otherwise healthy infants.

Which repair is best for my son?

The method your son’s urologist chooses will depend on a number of factors. These include the degree of hypospadias and how much the penis curves. The surgeon won’t know the complete situation until the operation is under way. Surgeons who do hypospadias repair must be familiar with many techniques. Sometimes even a mild distal hypospadias may turn out to need a more complex repair. Most hypospadias repairs are done by pediatric urologists with special training and skill.

How do I care for my son’s wound after surgery?

Hypospadias repair wounds don’t call for special care to heal the right way. The surgeon may choose from many band age types or not use any at all. The surgeon will instruct you on care of the wound and bathing. If your son has a catheter, it may be left to drain into diapers. Diapers can be changed as usual. If your son is older, the catheter may be connected to a bag. Your health care provider will teach you how to empty the bag. Catheters are often kept in place for 5 days to 2 weeks.

How long will the healing take?

Wound healing from hypospadias repair starts at once. But it may take many months for it to heal fully. There may be swelling and bruising early on. This gets better over a few weeks. Sometimes the skin of the penis heals with what seems like an unsightly ruffle. There may also be more obvious complications. Any recommendations for more surgery won’t be made for at least 6 months, to let the tissues heal. Many slight imperfections will also resolve during this time.

If my child still has problems after many operations, can his hypospadias still be repaired?

Yes. Luckily, most operations are a success the first time. Yet, a few children need more surgery because of complications. Most of them will have good results the second time. Still, a few may have problems that lead to even more surgery. But these problems can be fixed.

Contact Us

Ayesha Bashir Hospital G.T Road Julyani,Gujrat PAKISTAN (+92)53-3558057 info@imperialaesthetic.com