Hypospadias
Hypospadias is found in approximately one in every 200 boys who are born.
It is a type of birth defect characterized by the meatus not being at the tip of the penis. It will instead be elsewhere on the penis.
Preparation
Before the procedure, the doctor will start by learning more about the child’s general health and then conducting a physical examination. It is important that the doctor knows about all medications and conditions associated with the child.
Children may need to refrain from food or drinks shortly before the procedure. The doctor will let the parents know about any special preparation considerations. It is imperative that these are all followed exactly.
Procedure Options
There are a number of options that can be considered to correct hypospadias. In general, the surgery is recommended when the child is between six months and two years old. The purpose of surgery is to:
- Create a new urethra
- Creating a new meatus in the proper location
- Straightening the penis
Categories of Hypospadias Repair
Orthoplasty may be performed to straighten the penis
Glanuloplasty or meatoplasty is done to reconstruct the penis’ head and build a new opening
Skin coverage using grafts can be performed to complete the hypospadias repair
Urethroplasty may be performed to allow semen and urine to flow properly via rebuilding the urethra
Scrotoplasty can be performed to repair the scrotum
Considerations
The patient’s exact condition will determine which surgery is needed. If skin coverage is needed, skin from the mouth is typically used. Boys who have the repair after puberty usually need it done in two stages. Each procedure will be four to six months apart. No matter when the surgery is performed, it is possible to need additional surgery either shortly after the first or later in life.
Patients may have a catheter inserted into the urethra as part of the surgery. It may need to remain in place for about one to two weeks after the procedure is complete. The exact length of time the child will be in surgery varies. Parents are generally provided with an estimate once the surgeon knows what will be required to make the necessary repairs.
Recovery
Following the procedure, the penis is typically secured to the child’s stomach using medical tape. A plastic cup or dressing may be placed to protect the surgical area.
A catheter is frequently used to ensure that urine drains as it should. Patients should consume sufficient fluids to ensure adequate urination.
Most children are able to go home the same day and parents are provided with detailed care instructions.
Most children do fine following this type of surgery and experience results that last for the rest of their lives. For the most part, the penis functions and looks normal.