Page 1 - Hypospadias

Urological Health
Hypospadias
Hypospadias: a common paediatric condition.
W hat is Hypospadias?
Hypospadias is a common penile condition which
occurs in 1 in 250 male babies.
The penis may have one or more of the following
features:
1. Penile opening on the underside of the shaft
2. Uneven foreskin
3. Bend of the penis (chordee) usually downwards
with erections
What causes hypospadias?
Hypospadias generally occurs by chance. There
is nothing that can be done to prevent this during
pregnancy. It can be seen in family members;
however, having one child with hypospadias does not
mean that the next child will have hypospadias.
Environmental factors have been associated with
hypospadias however nothing has been consistently
found.
Associated Problems
The two primary functions of the penis are to allow a
male to urinate and to allow semen to get a partner
pregnant during intercourse. With mild hypospadias
these functions can still be performed and the
decision to surgically correct hypospadias relates to
altering the appearance.
With more severe hypospadias, surgery may be
necessary to allow normal function. No matter what
degree of hypospadias, the penile sensation is normal.
Hypospadias often occurs on its own and does not
mean there are any other medical problems. When
hypospadias is identified as the only medical problem,
no further tests are required.
Treatment
Mild cases of hypospadias may not require surgery
however; definitive correction of hypospadias requires
surgery. This is often done between 6 and 18 months
of age due to quick recovery and lack of long term
memories; however, it can be done at any age.
In severe cases of hypospadias, physicians may
discuss preoperative hormones (testosterone)
to enlarge the penis. There are many types of
hypospadias repairs however all require a full
anesthetic where your child goes to sleep with a
breathing tube in place. The surgery may take a few
hours. After the surgery your child may be left with a
tube coming out of the urinating channel which will
be left in place for 2-14 days to allow the repair to
heal. There may be a dressing on the penis as well
which is removed within the first few days after surgery.
Your child may have to take antibiotics and bladder
spasm medications following the procedure.
In severe hypospadias, multiple surgeries may be
required.
After the surgery your child’s penis will look very
bruised and swollen. It can take quite a few weeks for
the penis to look normal.
Hypospadias surgery generally results in a good
outcome. Children may however require more
surgeries for complications. Complications can occur
in 10% of children with mild hypospadias and up to
50% of those with severe hypospadias. Complications
can include fistulas, stricture and opening of the
wound. A fistula is a separate hole from the urinating
channel to the skin. It can form anywhere along the
surgery line and is noticed as your child urinates.
Parents may notice that there are 2 or more streams.
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