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    Hypospadias

    What is Hypospadias?

     Hypospadias, means that the opening of his urethra (through which both urine and semen passes) is located under the penis rather than at the tip. The urethral opening can be located at any point along the underside of the penis.

    • Anterior or distal (near the tip of the penis): This is the mildest form of hypospadias, occurring in about 50 percent of cases.
    • Middle (midway up the penis): Considered moderate hypospadias, this accounts for about 30 percent of cases.
    • Posterior or proximal (at the scrotum or perineum): This is the most severe kind of hypospadias, and occurs in 20 percent of cases.

    What are the problems with Hypospadias?

    If left untreated, more severe forms of hypospadias can interfere with sexual intercourse when your child is an adult.

    What are the signs and symptoms of Hypospadias?

    • a downward urinary spray (in older children with more severe hypospadias, he has to sit down to urinate)
    • a downward curvature of the penis, called “chordee”
    • a “hooded” appearance to the penis, caused by extra foreskin along the top side
    • an abnormal appearance of the tip of the penis (the glans)

    In some cases, boys born with hypospadias may also have undescended testis and inguinal hernia.

    How Hypospadias managed?

    The first step in treatment is forming an accurate and complete diagnosis. Hypospadias can only rarely be seen on ultrasound, so doctors typically diagnose it just after the baby is born, during his first physical examination. The location of the urethral opening (or “pee hole”) on the underside of child’s penis indicates what type of hypospadias is.

    What is the treatment option?

    Surgery can correct hypospadias and give your child a normal-looking, fully functional penis. In very mild form of hypospadias, he may not need surgery because his condition is unlikely to affect his future as a husband and a father.

    What are the surgical goals of Hypospadias surgery?

    There are three main goals:

    • to reposition the opening of urethra at the tip of the penis (urethroplasty)
    • to straighten the penis, if chordee is present (orthoplasty)
    • to improve the outward appearance of the penis (removing the hooded foreskin)

    How surgery is planned?

    It is done under general anesthesia , complete the repair in one session. Some of more severe cases, however, require two sessions spaced about six months apart.

    What is postoperative protocol?

    • Antibiotic ointment, to be applied to the penis several times a day
    • Oral antibiotics and anlagesics
    • Antispasmodic medication, to alleviate bladder spasms

    How is follow-up after Hypospadias surgery.

    We will remove the catheter during a follow-up 10 days after the surgery.Later patient will be reviewed a month after the surgery, and then again a few months later, so we can make sure the healing is coming along.

    When can we appreciate final results?

    We can expect to see the full results of successful surgery within six months.

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