#Hypospadias Repair Surgery in Delhi

[supertechsurvey]

Urethra and Penile Surgery (UPS) is home to the best and most respected urology hospital in Delhi and NCR. Book a free online consultation with the best Urologist in Delhi.

Urethra and Penile Surgery (UPS) is a center of exclusivity & excellence for Andrology and Reconstructive Urology. We specialize in Urethral stricture, Peyronie’s disease, Erectile dysfunction, Penile implant placement & revision, Hypospadias repair, congenital penile curvature correction and other disorders of the male external genitalia such as epispadias, hydrocele, phimosis etc. Urethra and Penile Surgery (UPS) is home to the best and most respected urology hospital in Delhi and NCR. Urethra and Penile Surgery (UPS) hospital’s Department of Urology has state-of-the-art diagnostic equipment and laboratories for diagnosing various urinary tract disorders. You can receive both in-patient and out-patient treatments depending on your medical condition. We are a regional, national, and international tertiary referral center dedicated to the treatment of disorders of the male Urethra, External Genitalia and Andrology. We have been managing patients from more than 35 countries across the globe and patients from more than 15 Indian states with good success rate.We encourage our patients to come for a follow up after the surgery for better clinical outcome.

[medical6270-blog]

Hypospadias Repair Surgery in India. Hypospadias is a relatively rare congenital condition where the opening of the penis is on the underside of the organ. This condition is more common in infants with a family history of hypospadias. The penis may curve down in an infant and the baby may spray while urinating. It usually requires surgical correction to restore the proper flow of urine.

[bestpediatricurologist]

Hypospadias Surgery In Delhi - Dr. Prashant Jain

Hypospadias Surgery

Hypospadias is a birth defect in boys in which the opening of the urethra is not located at the tip of penis. In these cases the tube that carries urine from the bladder to outside of the body or the urethra does not end at the tip of the penis, rather ends on the underside of the penis. It can me mild or severe, in severe cases , the urethra opens at the middle of the penis or in some cases even behind the scrotum.

The treatment is aimed to facilitate the following.

Urine should pass in a forward way

The penis should be straight when erect

The penis should look as normal as possible

The surgery for this condition is known as Urethroplasty. If chordee is present then this is corrected to straighten the penis. The success of the operation and the ‘normality’ that can be achieved depends on the severity of the hypospadias.

Why is Hypospadias Surgery needed?

Hypospadias Surgery is performed generally when boys are 1 Year to 2 years old. If the hypospadias is mild, with the opening of the urethra just a little down from normal and with no bending of the penis, in that case treatment may not be needed. However, in the most cases an operation is required to correct the hypospadias. This can usually be done in one operation. However, if the hypospadias is more complicated, two operations may be necessary.

Preparation before the Surgery:

As mentioned earlier, the surgery isn’t a major one and does not require very specific pre-surgery preparations. The child’s health care provider may ask for the medical history of the child and suggest for a complete medical checkup before the surgery.

The procedure of the surgery:

The procedure is pretty simple and direct. The tissue extracted from the foreskin or some other part is used to make a tube. This tube is used to increase the length of the urethra. The extension is done so that the urethra opens at the tip of the penis. In many cases, during the surgery, an external tube called a Catheter is sewn or fastened to the head of the penis. This is done to keep it in place and help it retain a proper shape. It is usually removed after 1 – 2 weeks of the surgery. In many cases of Hypospadias, boys have a non-uniform or underdeveloped foreskin. This foreskin is circumcised at the end of the surgery. Most of the stitches used in this surgery are of a special type that dissolves on their own after the surgery and need not be removed manually.

Post surgery Care:

After the surgery, the child’s penis is taped to his belly so that there is a minimal movement to prevent any casualties. Often, the penis is protected by doing bulky dressing around the surgical area. A urinary Catheter is placed so that the urine can flow out of the dressed area into the diaper. The child is encouraged to drink fluid so that he will urinate more, this prevents pressure from building up in the urethra. The child is given medicines to help relieve the pain. In most of the cases, the child is discharged within a day. A urinary catheter may be needed for 6-14 days after the surgery. The penis of your child may be seen swollen and bruised but it’s nothing to worry about. The whole healing process takes around 6-7 weeks.

What are the risks of Hypospadias repair ?

All surgery carries a small risk of bleeding during or after the operation. For about one in ten boy, the original hole opens up again (fistula), and the patient passes urine through two holes. If this happens, the patient will need the operation again.

Tag =hydronephrosis in child treatment delhi, best pediatric urologist in delhi,best pediatric urologist in india, Undescended Testis In Children,

[drprashantjain]

Hypospadias Surgery in Delhi by Dr. Prashant Jain

Tag:  Hypospadias Surgery in Delhi

Hypospadias is a birth defect in boys in which the opening of the urethra is not located at the tip of penis. In these cases the tube that carries urine from the bladder to outside of the body or the urethra does not end at the tip of the penis, rather ends on the underside of the penis. It can be mild or severe, in severe cases, the urethra opens in the middle of the penis or in some cases even behind the scrotum.

The treatment is aimed to facilitate the following.

Urine should pass in a forward way

The penis should be straight when erect

The penis should look as normal as possible

The surgery for this condition is known as Urethroplasty. If chordee is present then this is corrected to straighten the penis. The success of the operation and the ‘normality’ that can be achieved depends on the severity of the hypospadias.

Why is Hypospadias Surgery needed?

Hypospadias Surgery is performed generally when boys are1 Year to 2 years old. If the hypospadias is mild, with the opening of the urethra just a little down from normal and with no bending of the penis, in that case treatment may not be needed. However, in most cases an operation is required to correct the hypospadias. This can usually be done in one operation. However, if the hypospadias is more complicated, two operations may be necessary.

Preparation before the Surgery:

As mentioned earlier, the surgery isn’t a major one and does not require very specific pre-surgery preparations. The child’s health care provider may ask for the medical history of the child and suggest for a complete medical checkup before the surgery.

The procedure of the surgery:

The procedure is pretty simple and direct. The tissue extracted from the foreskin or some other part is used to make a tube. This tube is used to increase the length of the urethra. The extension is done so that the urethra opens at the tip of the penis. In many cases, during the surgery, an external tube called a Catheter is sewn or fastened to the head of the penis. This is done to keep it in place and help it retain a proper shape. It is usually removed after 1 – 2 weeks of the surgery. In many cases of Hypospadias, boys have a non-uniform or underdeveloped foreskin. This foreskin is circumcised at the end of the surgery. Most of the stitches used in this surgery are of a special type that dissolves on their own after the surgery and need not be removed manually.

Post-surgery Care:

After the surgery, the child’s penis is taped to his belly so that there is a minimal movement to prevent any casualties. Often, the penis is protected by doing bulky dressing around the surgical area. A urinary catheter is placed so that the urine can flow out of the dressed area into the diaper. The child is encouraged to drink fluid so that he will urinate more, this prevents pressure from building up in the urethra. The child is given medicines to help relieve the pain. In most of the cases, the child is discharged within a day. A urinary catheter may be needed for 6-14 days after the surgery. The penis of your child may be seen swollen and bruised but it’s nothing to worry about. The whole healing process takes around 6-7 weeks.

What are the risks of Hypospadias repair ?

All surgery carries a small risk of bleeding during or after the operation. For about one in ten boy, the original hole opens up again (fistula), and the patient passes urine through two holes. If this happens, the patient will need the operation again.

[pedsurgerydelhi]

Reconstructive Urology In India - Hypospadias Repair, Ureteric re-implant, Pyeloplasty, Orchiopexy etc. Treatment by Dr. Prashant Jain

Reconstructive Urology In India

Reconstructive urology is used to restore urinary, sexual, and reproductive functions in patients who have had congenital conditions or urethral strictures. It is a highly specialized field of male urology. It also brings back the functions to the genitourinary tract.

The reconstructive urology procedures include – pyeloplasty, ureteric re-implant, hypospadias repair, bladder exstrophy repair, bladder augmentation, bladder neck repair, circumcision, and orchiopexy.

Pyeloplasty

It is the surgical reconstruction of the renal pelvis. The renal pelvis is a part of the kidney. Pyeloplasty is done to drain and decompress the kidney. Almost all cases are to relieve a ureteropelvic junction obstruction or shortly known as UPJ obstruction. Just the tissues where the ureter is obstructed is cut, and the original ureter is repositioned and attached back to the healthy renal pelvic tissue above.

Ureteric re-implant

Ureteric re-implant is generally used to treat the refluxes. This surgery aims to fix the tubes that connect the kidneys to the bladder. Ureteric re-implant creates a position change for the tubes at the point where they join the bladder to stop urine from backing up into the kidneys.

Hypospadias Repair

Hypospadias repair is a surgical method by which a birth defect on the opening of the penis is corrected. The defect causes the Urethra to end up on the underside of the penis itself. The local tissue is used to reconstruct the Urethra and to bring the opening at the tip of the penis.

Bladder Exstrophy Repair

Bladder Exstrophy repair surgery is done to correct the birth defect of the bladder that grows outside the abdominal wall. Surgeons close the bladder and the abdomen, repair the Urethra and the outer sex organs. There are basically two methods to do this. A complete repair and a modern staged. The modern stage involves three operations. One within 72 hours after birth, at age 6 to 12 months and again at 4 to 5 years. The first closes the bladder and the abdomen, and the second to repair the Urethra and sex organs.

Bladder augmentation

Bladder augmentation is the surgical method to avoid urine leakage or high pressure by augmenting the bladder so that it can store more urine. A section of the bowel or stomach is used to make the bladder larger.

Bladder Neck Repair

Adequate circumferential muscular support is required after the reconstruction of Urethra. Facial or muscular or artificial slings are used to support the bladder. The surgery to do so is called Bladder neck repair.

Circumcision

It is the surgical procedure to remove the foreskin from the penis. It reduces the risk of infections. Also, it helps in situations where the person is unable to retract his foreskin. The foreskin is cut after proper anesthesia.

Orchiopexy

Orchiopexy is done to move an undescended testicle into the scrotum. This surgery is done for kids if the testicles don’t descend on its own until six months of age. The groin is cut by the surgeon, and the testes are located. A pocket is made in the scrotum, and it is properly placed into the sack, and then the groin is stitched back. If you have any problem related to Reconstructive urology you may consult the Best pediatric urologist in Delhi, Dr. Prashant Jain. He is one of the best pediatric urologists in India.

Tag = best pediatric urologist in delhi, best pediatric surgeon in delhi

For more information = http://www.pedsurgerydelhi.com/

[mtcentre-blog]

TREATMENT

Hypospadias is completely treatable. However, it is completely treated in stages depending upon the severity of the condition and associated complications.

Hypospadias is treated by surgical intervention and necessarily needed to be operated. Ideally, the surgery is often performed during the first year of a boy’s life for a better clinical outcome.

The objective of the hypospadias repair is to:

· Correct the downward curvature,

· Reconstruct the urethra so that the urethra is of adequate size and with the opening at the usual place i.e, at the tip of the penis,

· Provide a normal cosmetic appearance of the penis.

[hellohealing123me-blog]

Hypospadias Repair Surgery in India. Hypospadias is a relatively rare congenital condition where the opening of the penis is on the underside of the organ. This condition is more common in infants with a family history of hypospadias. The penis may curve down in an infant and the baby may spray while urinating. It usually requires surgical correction to restore the proper flow of urine. This usually takes place before 18 months of age.

[best-pediatric-surgeon-in-india]

What is hypospadias?

Hypospadias is a birth defect in boys in which the opening of the urethra is not located at the tip of the penis. In boys with hypospadias, the urethra forms abnormally during 8-14 weeks of pregnancy. The abnormal opening can be anywhere, from just below the end of the penis to the scrotum. Depending on the site of the opening they are classified as distal (minor type)and proximal (major type).

Types of Hypospadias:

The types of hypospadias a boys has depends on location of the opening of the urethra:

Subcoronal: The opening of the urethra is located somewhere near the head of the penis.

Midshaft: The opening of the urethra is located along the shaft of the penis.

Penoscrotal: The opening of the urethra is located where the penis and scrotum meet.  

Understanding the normal penis and urethra

The normal urethra is a tube through which that urine flows out of the bladder. It passes through the penis. The opening of the urethra (meatus) is normally at the end of the penis, partly covered by the foreskin.

What is the penis like in hypospadias?

The main problem is that the urethra opens on the underside of the penis instead of at the end of the penis. The opening can be anywhere from just below the normal position (mild) to as far back as the base of the scrotum (severe).

Hypospadias may also include the following:

A hooded appearance of the foreskin. This is because the foreskin does not develop on the underside of the penis.

Tightening of the tissues on the underside of the penis (called ‘chordee’). This pulls the penis down and it cannot fully straighten. This is commanly seen in severe hypospedias

What problems can hypospadias cause?

Problems are likely to occur if hypospadias is left untreated. The further back the opening of the urethra is, the more severe the problems are likely to be.

Passing urine is different to normal. A baby in nappies will have no problem. However, when older, the urine stream may not be able to be directed forward into a urinal. When going to the toilet the urine is likely to ‘spray’ backwards. Sitting on a toilet may be needed to pass urine without mess.

Chordee causes bending of the penis. This is more noticeable when the penis is erect. Sexual intercourse may be difficult or impossible in severe cases.

Psychological problems about being ‘different’ to normal are common.

How common is hypospadias and what causes it?

About 1 in 300 boys are born with some degree of hypospadias. It seems to be getting more common. The reason why the penis does not develop properly is still not clear. The development of the penis while the baby is growing in the womb (uterus) is partly dependent on the male sex hormones such as testosterone.

What is the treatment for hypospadias?

If the hypospadias is mild, with the opening of the urethra just a little down from normal and with no bending of the penis, no treatment may be needed. However, in most cases an operation is required to correct the hypospadias. This can usually be done in one operation. However, if the hypospadias is more complicated, two operations may be necessary. The operation is usually done when the child is around 6-18 months old. The goals of treatment are:

For urine to be passed in a forward way.

For the penis to be straight when erect.

For the penis to look as normal as possible.

The position of the opening of the urethra is altered. Also, if chordee is present then this is corrected to allow the penis to straighten. The foreskin is usually used during the operation to make the new urethra so it is important that a circumcision is not done before the corrective surgery is performed.depanding on the surgery of hypospedias surgeryes

The success of the operation and the ‘normality’ that can be achieved depends on the severity of the hypospadias done in single as two stage

What happens after the operation?

Your son will be brought back to the ward to recover. He will be able to eat and drink after 3 hours He will have a dressing on his penis and a tube draining away the urine. The patients are usually kept for 2 days in the hosptial and then discharged. The dressing and tube need to stay in place for 10 days, then you will need to come back to the Hospital to have them removed.

What are the risks of hypospadias repair?

All surgery carries a small risk of bleeding during or after the operation.

For about one in ten boys, the original hole opens up again, so that your son passes urine through two holes. This can occur at any time after the operation. If this happens, your son will need the operation again. Occasionally, the new hole at the tip of the penis is too small, so your son will need another operation to make the hole larger. The drainage tube can irritate the inside of the bladder, which is painful. This is called ‘bladder spasm’. To reduce this, your son will be given ‘bladder spasm medicine’ as well as pain relief.

When you get home

Your son will go home with the catheter and dressing in place. Staff on the ward will give you full details of how to care for these at home.

You should encourage, to drink plenty of water/fluids.

Your child may need some pain relief when you get home.

You should not have a bath or shower until after the dressing comes off.

Putting your son in two nappies at a time can protect the area from accidental knocks.

Your son should not ride a bicycle or any sit-on toy until the area has healed.

Try to avoid getting the dressing dirty when nappy changing. If this happens, dab any faeces off with a damp cloth.

As there is a small risk of infection, your son will need to take antibiotics until he returns for his outpatient appointment.

Post Op Teaching

Case of cethetea

How to empty urine bag

How to avoid kinking, twisting, blockage of catheter or stent

May empty straight into nappy

How to tape drainage bag to leg allowing a child to be mobile

Never clamp off catheter

Child encouraged to increase fluid intake

Twice daily sponging recommended and loose clothing

No outdoor activity

You should contect:

your child is in a lot of pain and pain relief does not seem to help

there is any oozing from the wound

the dressing falls off/becomes wet

the tube stops or reduces the amount of urine draining from it or the tube falls out

What happens next?

You will be called for dressing as per instructions given in discharge summary. This can be painful, so before hand make sure that your son has the maximum dose of pain relief possible but no bladder spasm medicine. When the dressing has been removed, the penis will look red and swollen. This is normal and will settle down within a few days.

Tags = hypospadias surgery in delhi, best pediatric urologist in delhi, best pediatric urologist in india, best pediatric surgeon in delhi, best pediatric surgeon in india

[drprashantjain]

Care after Hypospadias surgery in Delhi

Hypospadias is a common congenital problem which can be corrected by surgery. Post operative care of hypospadias surgery is equally important as it needs care of pain, infection, dressing and urinary tube (catheter).

Post operative care after hypospadias repair Includes :

The child will require analgesics, usually paracetamol for surgical site pain. He may have spasmodic pains because of the urinary catheter which can sometimes irritate the bladder wall. To prevent this child will be given anticholinergic drugs (Tropan).

Besides the child will be given antibiotics to prevent the risk of infection and laxatives in case of constipation.

The most important is to take care of urinary pipe (catheter). We prefer using double diaper in children less than 3 years old. The diaper which is inside needs to be changed if it gets soiled with stool while the outer diaper which soaks urine needs to be changed on regular basis. The purpose of using double diaper is to avoid mixing of stool and urine and thus avoiding the risk of infection.

Parents should ensure that the catheter is continuously draining urine. They can check this by changing the diaper regularly or emptying the urinary bag in regular intervals. In case the catheter is not draining the urine, one should check for any kinking of the catheter, if this is not the possibility then they have to contact the doctor or report in the emergency. Sometimes the blocked catheter may require flushing with saline.

In case if dressing gets soaked with urine you can use a hair dryer to make it dry (at same time ensure that the catheter is draining urine).

The child will be called after 7 to 10 days to remove the dressing and catheter (or before if it gets soaked with blood or urine.)

He will not be able to take bath till the time catheter is removed, but careful sponging can be done.

After the dressing is removed, he can take shower. He will be advised for sitz bath and application of local antibiotic ointments for 10 days.

You should contact doctor/emergency if the child has lot of pain, dressing gets soaked or has fallen off and if catheter is not draining urine.

Tag = best pediatric urologist in delhi, best pediatric urologist in india, best pediatric surgeon in india

[drprashantjain]

Reconstructive Urology In India

Reconstructive urology is used to restore urinary, sexual, and reproductive functions in patients who have had congenital conditions or urethral strictures. It is a highly specialized field of male urology. It also brings back the functions to the genitourinary tract.

The reconstructive urology procedures include – pyeloplasty, ureteric re-implant, hypospadias repair, bladder exstrophy repair, bladder augmentation, bladder neck repair, circumcision, and orchiopexy.

Pyeloplasty

It is the surgical reconstruction of the renal pelvis. The renal pelvis is a part of the kidney. Pyeloplasty is done to drain and decompress the kidney. Almost all cases are to relieve a ureteropelvic junction obstruction or shortly known as UPJ obstruction. Just the tissues where the ureter is obstructed is cut, and the original ureter is repositioned and attached back to the healthy renal pelvic tissue above.

Ureteric re-implant

Ureteric re-implant is generally used to treat the refluxes. This surgery aims to fix the tubes that connect the kidneys to the bladder. Ureteric re-implant creates a position change for the tubes at the point where they join the bladder to stop urine from backing up into the kidneys.

Hypospadias Repair

Hypospadias repair is a surgical method by which a birth defect on the opening of the penis is corrected. The defect causes the Urethra to end up on the underside of the penis itself. The local tissue is used to reconstruct the Urethra and to bring the opening at the tip of the penis.

Bladder Exstrophy Repair

Bladder Exstrophy repair surgery is done to correct the birth defect of the bladder that grows outside the abdominal wall. Surgeons close the bladder and the abdomen, repair the Urethra and the outer sex organs. There are basically two methods to do this. A complete repair and a modern staged. The modern stage involves three operations. One within 72 hours after birth, at age 6 to 12 months and again at 4 to 5 years. The first closes the bladder and the abdomen, and the second to repair the Urethra and sex organs.

Bladder augmentation

Bladder augmentation is the surgical method to avoid urine leakage or high pressure by augmenting the bladder so that it can store more urine. A section of the bowel or stomach is used to make the bladder larger.

Bladder Neck Repair

Adequate circumferential muscular support is required after the reconstruction of Urethra. Facial or muscular or artificial slings are used to support the bladder. The surgery to do so is called Bladder neck repair.

Circumcision

It is the surgical procedure to remove the foreskin from the penis. It reduces the risk of infections. Also, it helps in situations where the person is unable to retract his foreskin. The foreskin is cut after proper anesthesia.

Orchiopexy

Orchiopexy is done to move an undescended testicle into the scrotum. This surgery is done for kids if the testicles don’t descend on its own until six months of age. The groin is cut by the surgeon, and the testes are located. A pocket is made in the scrotum, and it is properly placed into the sack, and then the groin is stitched back. If you have any problem related to Reconstructive urology you may consult the Best pediatric urologist in Delhi, Dr. Prashant Jain. He is one of the best pediatric urologists in India.

Tags:best pediatric surgeon in india best pediatric surgeon in delhi  best pediatric urologist in india   best pediatric urologist in delhi

[bestpediatricurologist]

Hypospadias Surgery In Delhi

Hypospadias Surgery

Hypospadias is a birth defect in boys in which the opening of the urethra is not located at the tip of penis. In these cases the tube that carries urine from the bladder to outside of the body or the urethra does not end at the tip of the penis, rather ends on the underside of the penis. It can me mild or severe, in severe cases , the urethra opens at the middle of the penis or in some cases even behind the scrotum.

The treatment is aimed to facilitate the following.

The penis should be straight when erect

The penis should look as normal as possible

The surgery for this condition is known as Urethroplasty. If chordee is present then this is corrected to straighten the penis. The success of the operation and the ‘normality’ that can be achieved depends on the severity of the hypospadias.

Why is Hypospadias Surgery needed?

Hypospadias Surgery is performed generally when boys are 1 Year to 2 years old. If the hypospadias is mild, with the opening of the urethra just a little down from normal and with no bending of the penis, in that case treatment may not be needed. However, in the most cases an operation is required to correct the hypospadias. This can usually be done in one operation. However, if the hypospadias is more complicated, two operations may be necessary.

Preparation before the Surgery:

As mentioned earlier, the surgery isn’t a major one and does not require very specific pre-surgery preparations. The child’s health care provider may ask for the medical history of the child and suggest for a complete medical checkup before the surgery.

The procedure of the surgery:

The procedure is pretty simple and direct. The tissue extracted from the foreskin or some other part is used to make a tube. This tube is used to increase the length of the urethra. The extension is done so that the urethra opens at the tip of the penis. In many cases, during the surgery, an external tube called a Catheter is sewn or fastened to the head of the penis. This is done to keep it in place and help it retain a proper shape. It is usually removed after 1 – 2 weeks of the surgery. In many cases of Hypospadias, boys have a non-uniform or underdeveloped foreskin. This foreskin is circumcised at the end of the surgery. Most of the stitches used in this surgery are of a special type that dissolves on their own after the surgery and need not be removed manually.

Post surgery Care:

After the surgery, the child’s penis is taped to his belly so that there is a minimal movement to prevent any casualties. Often, the penis is protected by doing bulky dressing around the surgical area. A urinary Catheter is placed so that the urine can flow out of the dressed area into the diaper. The child is encouraged to drink fluid so that he will urinate more, this prevents pressure from building up in the urethra. The child is given medicines to help relieve the pain. In most of the cases, the child is discharged within a day. A urinary catheter may be needed for 6-14 days after the surgery. The penis of your child may be seen swollen and bruised but it’s nothing to worry about. The whole healing process takes around 6-7 weeks.

What are the risks of Hypospadias repair ?

All surgery carries a small risk of bleeding during or after the operation. For about one in ten boy, the original hole opens up again (fistula), and the patient passes urine through two holes. If this happens, the patient will need the operation again.

[best-pediatric-surgeon-in-india]

Hypospadias surgery in delhi

What is hypospadias?

Hypospadias is a birth defect in boys in which the opening of the urethra is not located at the tip of the penis. In boys with hypospadias, the urethra forms abnormally during 8-14 weeks of pregnancy. The abnormal opening can be anywhere, from just below the end of the penis to the scrotum. Depending on the site of the opening they are classified as distal (minor type)and proximal (major type).

Types of Hypospadias:

The types of hypospadias a boys has depends on location of the opening of the urethra:

Subcoronal: The opening of the urethra is located somewhere near the head of the penis.

Midshaft: The opening of the urethra is located along the shaft of the penis.

Penoscrotal: The opening of the urethra is located where the penis and scrotum meet.  

Understanding the normal penis and urethra

The normal urethra is a tube through which that urine flows out of the bladder. It passes through the penis. The opening of the urethra (meatus) is normally at the end of the penis, partly covered by the foreskin.

What is the penis like in hypospadias?

The main problem is that the urethra opens on the underside of the penis instead of at the end of the penis. The opening can be anywhere from just below the normal position (mild) to as far back as the base of the scrotum (severe).

Hypospadias may also include the following:

A hooded appearance of the foreskin. This is because the foreskin does not develop on the underside of the penis.

Tightening of the tissues on the underside of the penis (called ‘chordee’). This pulls the penis down and it cannot fully straighten. This is commanly seen in severe hypospedias

What problems can hypospadias cause?

Problems are likely to occur if hypospadias is left untreated. The further back the opening of the urethra is, the more severe the problems are likely to be.

Passing urine is different to normal. A baby in nappies will have no problem. However, when older, the urine stream may not be able to be directed forward into a urinal. When going to the toilet the urine is likely to ‘spray’ backwards. Sitting on a toilet may be needed to pass urine without mess.

Chordee causes bending of the penis. This is more noticeable when the penis is erect. Sexual intercourse may be difficult or impossible in severe cases.

Psychological problems about being ‘different’ to normal are common.

How common is hypospadias and what causes it?

About 1 in 300 boys are born with some degree of hypospadias. It seems to be getting more common. The reason why the penis does not develop properly is still not clear. The development of the penis while the baby is growing in the womb (uterus) is partly dependent on the male sex hormones such as testosterone.

What is the treatment for hypospadias?

If the hypospadias is mild, with the opening of the urethra just a little down from normal and with no bending of the penis, no treatment may be needed. However, in most cases an operation is required to correct the hypospadias. This can usually be done in one operation. However, if the hypospadias is more complicated, two operations may be necessary. The operation is usually done when the child is around 6-18 months old. The goals of treatment are:

For urine to be passed in a forward way.

For the penis to be straight when erect.

For the penis to look as normal as possible.

The position of the opening of the urethra is altered. Also, if chordee is present then this is corrected to allow the penis to straighten. The foreskin is usually used during the operation to make the new urethra so it is important that a circumcision is not done before the corrective surgery is performed.depanding on the surgery of hypospedias surgeryes

The success of the operation and the ‘normality’ that can be achieved depends on the severity of the hypospadias done in single as two stage

What happens after the operation?

Your son will be brought back to the ward to recover. He will be able to eat and drink after 3 hours He will have a dressing on his penis and a tube draining away the urine. The patients are usually kept for 2 days in the hosptial and then discharged. The dressing and tube need to stay in place for 10 days, then you will need to come back to the Hospital to have them removed.

What are the risks of hypospadias repair?

All surgery carries a small risk of bleeding during or after the operation.

For about one in ten boys, the original hole opens up again, so that your son passes urine through two holes. This can occur at any time after the operation. If this happens, your son will need the operation again. Occasionally, the new hole at the tip of the penis is too small, so your son will need another operation to make the hole larger. The drainage tube can irritate the inside of the bladder, which is painful. This is called ‘bladder spasm’. To reduce this, your son will be given ‘bladder spasm medicine’ as well as pain relief.

When you get home

Your son will go home with the catheter and dressing in place. Staff on the ward will give you full details of how to care for these at home.

You should encourage, to drink plenty of water/fluids.

Your child may need some pain relief when you get home.

You should not have a bath or shower until after the dressing comes off.

Putting your son in two nappies at a time can protect the area from accidental knocks.

Your son should not ride a bicycle or any sit-on toy until the area has healed.

Try to avoid getting the dressing dirty when nappy changing. If this happens, dab any faeces off with a damp cloth.

As there is a small risk of infection, your son will need to take antibiotics until he returns for his outpatient appointment.

Post Op Teaching

Case of cethetea

How to empty urine bag

How to avoid kinking, twisting, blockage of catheter or stent

May empty straight into nappy

How to tape drainage bag to leg allowing a child to be mobile

Never clamp off catheter

Child encouraged to increase fluid intake

Twice daily sponging recommended and loose clothing

No outdoor activity

You should contect:

your child is in a lot of pain and pain relief does not seem to help

there is any oozing from the wound

the dressing falls off/becomes wet

the tube stops or reduces the amount of urine draining from it or the tube falls out

What happens next?

You will be called for dressing as per instructions given in discharge summary. This can be painful, so before hand make sure that your son has the maximum dose of pain relief possible but no bladder spasm medicine. When the dressing has been removed, the penis will look red and swollen. This is normal and will settle down within a few days.

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