Hypospadias Surgery

HypospadiasHypospadias is a form of urological congenital defect that causes the penis to be deformed as well as not fully functional. This birth defect causes the urethra to be short and it does not reach the tip of the penis. Hypospadias is often accompanied with another condition called ‘chordee’ that shows an abnormal downward curve in the penis.

Types of Hypospadias

There are mainly four types of hypospadias that are classified according to the position of the urethra in the penis, these are:
  • Distal/Granular – This is the most common form of hypospadias and is formed when the opening of the urethra is found near the head of the penis.
  • Midshaft – In this type of hypospadias the opening of the urethra is found between the middle and lower part of the penile shaft.
  • Penoscrotal – This type of hypospadias is characterized by having the opening of the urethra on the scrotum.
  • Perineal – In this form of hypospadias the opening of the urethra is found behind the scrotal sac and is one of the most serious type of the birth defect.

Causes of Hypospadias

The main cause for the under-developed penis in the child during pregnancy is suspected to be a hormonal unbalance. During the 9th and 12th weeks of pregnancy the development of the fetus’ penis takes place in which the male hormones indicate the body to form the urethra and the foreskin and a hormonal interference may cause them to be undeveloped or abnormal.

How is Hypospadias diagnosed?

Hypospadias is usually detected at birth as the meatus is wrongly placed and the under-developed foreskin makes a ‘dorsal hood’ in the underside of the penis which leaves the tip of the penis exposed. The form of the foreskin is mostly a visible sign of hypospadias as well as a retracted testicle that is not inside the scrotum completely.

How is Hypospadias treated?

Hypospadias is a urological disorder that can be treated successfully through surgical corrective methods. There are many types of surgical approaches used to treat hypospadias. The main goal of a hypospadias procedure is to make a normal, straight penis with the urinary tract ending at the tip of the penis. An experienced pediatric urologist will run all necessary diagnostic tests to determine the position of the undeveloped urinary channel as well as the presence of chordee. The main aims of the surgery for hypospadias treatment are - to stretch the opening of the urethra to the tip of the penis that will allow the child to urinate normally while standing, to straighten the penis or correct the chordee that will allow normal erection, to improve the penis appearance as well as to prevent any type of fertility issues to develop later in the child’s life. The surgery begins with the child being put under general anesthesia. In case the surgeon feels the repaired urethra is not ready for passing the urine the surgeon will attach a small plastic tube called a catheter. This catheter is attached to the head of the penis and diverts the urine from the recently repaired part of the urethra. A dressing is applied to the head of the penis after the surgery to help prevent swelling. The surgeon will administer antibiotics and other medications to avoid any infection risks as well as stop bladder spasms.

What are the risks and complications associated with a Hypospadias surgery?

As is seen in any type of major surgery there are several risks and complications that may arise after a hypospadias surgery, such as:
  • Infection
  • Bleeding
  • Urinary channel complications
  • Anesthetic allergy
The other types of complications that may be seen in a few cases after a hypospadias surgery are:
  • Hole (fistula) on the penis
  • Scarring
The pediatric urologist will take every possible precaution in order to avoid risks and complications from arising after a hypospadias surgery. Although hypospadias surgery is critical to improve the appearance and restore the normal function in the penis an experienced and well-trained pediatric urologist can perform a successful corrective surgery.
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