What is hypospadias?
Hypospadias is a congenital abnormality of the penis that is characterized by an abnormal
Position of the urethral opening. Hypospadias appears in many forms. The urethral opening can be anywhere from the tip of the penis to the scrotum and sometimes as far back as the anus. The majority of cases occur with the opening near the head of the penis.
Types of Hypospadias
Hypospadias is associated with:
- Abnormal appearance of the glans penis (the head of the penis)
- Abnormal foreskin formation
- Downward bending of the penis(Chordee)
How common is hypospadias?
Incidence of hypospadias is reported to be between 1 per 250 to 300 male births. There is a familial tendency with increased rates when father or brothers have a history of hypospadias.
What causes hypospadias?
In the vast majority of cases, the cause of hypospadias is unknown. Occasionally it is due to abnormal hormone action. Even more rare is an abnormality of the sex chromosomes.
What causes hypospadias?
Mild hypospadias is generally a cosmetic problem. Children with moderate or severe
hypospadias may have functional problems. Boys may have difficulty with urination and be
unable to urinate standing up. Children with moderate or severe hypospadias also may have
some functional impairment with fertility. If your child also has curvature of the penis, this may affect his sexual function when he is older.
Children will not outgrow hypospadias and there are no medicines to fix it. Hypospadias has
been repaired surgically for many years with high success. As in most surgery, especially for
small children, hypospadias should be repaired by a specialist who does many repairs.
How is hypospadias repaired?
To bring the urethral opening to the head of the penis, a new urethral tube is created. This tube ismade from local skin and/or foreskin. If your son is suspected to have bending of the penis(Chordee), an artificial erection will be induced during surgery to determine if correction is necessary. Many absorbable sutures are used. These will dissolve and do not need to be removed. After making a new urethral tube, the surgeon will leave a catheter in the penis. This acts as a mold or cast while the new tube heals. This catheter will drain the urinary bladder so your son will not need to urinate. The catheter is usually removed eight to twelve days after surgery.
What else do I need to know about the surgery?
Depending on the severity of the hypospadias, surgery is usually 1-3 hours in duration. All children require general anesthesia for surgery. The risks of anesthesia are extremely small and will be explained to you by the anesthesiologist.
What are the possible complications of the surgery?
The most common complication from hypospadias surgery is the occurrence of a “fistula”. Fistula is an opening (hole) between the new urethral tube and the skin. The rate offistula formation is 10% at our hospital. The risk of a fistula forming depends upon the severity of your son’s hypospadias and whether he has undergone previous surgeries. If your child develops a fistula after surgery, in most cases it is repaired in a second operation six months later. Other complications of hypospadias surgery include complete disruption of the repair, hematoma (large blood clot) formation, proximal regression of the urethral opening, and urethral stricture (stenosis) formation.
What will my son’s penis look like after surgery?
Immediately after the surgery the penis will be very swollen and discolored. This will resolve
over the next few weeks. The ultimate appearance of your son’s penis is dependent on the
severity of hypospadias, whether he has had previous surgery, and the shape and size of his penis prior to surgery. After surgery the appearance would be that of a circumcised penis.
