Hypospadias
A defect in penis by birth
Hypospadias is a congenital anomaly in the penis in which the urethra does not open from its usual location in the head of the penis.
Hypospadias is a congenital anomaly in the penis in which the urethra does not open from its usual location in the head of the penis. It is the second-most common birth abnormality of the male genitalia, affecting about one of every 250 males at birth. Roughly 90% of cases are the less serious, in which the urethral opening (the meatus) is on or near the head of the penis. The remainder have the meatus all the way back on the shaft of the penis, near or within the scrotum. In most cases, the foreskin is less developed and does not wrap completely around the penis, leaving the underside of the glans uncovered. Also, a downward bending of the penis may occur when erect as seen during morning time. They also have underdeveloped penile length and girth.
Hypospadias can be associated with any other congenital condition also. A karyo type and endocrine evaluation should be performed to detect intersex conditions or hormone deficiencies that have major health risks.
Living with hypospadias can be emotionally challenging for the child and the family. The child is often ridiculed by his friends, he cannot stand and pee and if not corrected can lead to marital problems in life. It is considered as a taboo to talk about any condition of penis. Such children have low self esteem and confidence in their teenage years. Secrecy about the condition can complicate emotional pain.
Treatment of Hypospadias
Hypospadias is not a serious medical condition. The deformity of the urethral opening causes spraying of urine rather than a normal stream. Therefore, patient has to sit and micturate. Chordee is a condition, the downward curvature of the penis makes sexual penetration difficult. For these reasons, parents of children with hypospadias seek, a surgery for the condition.
Surgery can extend the urinary channel or tube to the end of the penis, straighten bending, and/or change the foreskin depending on the desire of the patient.
If the penis is small, testosterone or human chorionic gonadotrop in (hCG) injections may be given with consent to enlarge it before surgery as this will increase the chance of a successful urethral repair also.
Surgical repair of severe hypospadias may require multiple procedures. Preputial skin is often used for grafting and circumcision should be avoided before repair. In patients with severe hypospadias, surgery often produces unsatisfactory results, such as scarring, curvature, or formation of urethral fistulas (opening through the skin along the course of the urethra), diverticula (outpouching along the course of urethra), or strictures (narrowing). Rate of occurrence of complications has markedly reduced over the course of time and with surgeon experience.
Age of surgery for hypospadias
The results of surgery are probably not influenced by the age at which repair is done. Procedure is done in early childhood to eliminate the memory of some manipulation to the genitalia.
Surgery for Hypospadias
Hypospadias repair is done under general anesthesia in children, most often supplemented by a nerve block to the penis or a caudal block to reduce the general anesthesia needed, and to minimize discomfort after surgery. It can be done under regional anesthesia.
Most distal and many proximal hypospadias are corrected in a single operation. However, those with the most severe condition having a urinary opening in the scrotum and downward bending of the penis are often corrected in a two-stage operation.
During the first surgery, the downward curvature is straightened. In the second surgery, the new urinary channel is completed created. Any complications may require additional interventions for repair.
Single stage procedures are
- Tubularized Incised Plate - most common operation, known as "TIP" repair or Snodgrass Repair.This procedure can be used for all distal hypospadias repairs, with success in 85%.
- Meatal Advancement and Glanuloplasty (MAGPI)
- MATHIEW flip flap
- ASOPA technique
Two staged procedures are done at the interval of six months. Techniques used are
- Bracka's technique
- Byar's technique
Outcome of surgery for hypospadias
After surgery, dressing is done to secure the repair. The dressing is changed every 5 to 7 days. The child is kept admitted in hospital for 14 days preferably till the catheter is removed.
Distal hypospadias operations are successful in over 90% of cases.
Most complications are discovered within six months after surgery, such as residual penile curvature or urine spraying or urinary fistulae.
Complications are usually corrected with another operation, most often delayed for at least six months after the last surgery to allow the tissues to heal sufficiently.
Shaping dreams through
Know your surgeon better
Best plastic surgeon, Dr. Amit Agarwal is an American Board Certified, extensively trained, and best Plastic & Aesthetic surgeon in Lucknow. He is the Chief Plastic Surgeon heading the Department of Plastic, Microvascular, and Craniofacial surgery at Vivekananda Polyclinic and Institute of Medical Sciences, Lucknow, U.P, India. He maintains a busy practice at Avadh and Nishat Hospital and his own center - Kayakriti Plastic Surgery & Dental Center. He was formerly a Consultant in the Department of Plastic Surgery and Burns at the prestigious SGPGI, Lucknow.
MS, DNB (General Surgery) MCh, DNB (Plastic Surgery),
MNAMS, FACS, FICS, FRCS (Edinburgh, UK)
His Credentials
Three pillars of kayakriti
Privacy
We believe your experience with us should be comfortable and hassle-free to make it one of your best lifetime experiences for yours. We, here at the clinic, take full precautions to maintain your privacy in any manner. We also provide a staff who will receive you from the gate and take you to the chamber directly if you demand.
Trust
Our Surgeon is highly qualified and internationally certified with a team of skilled staff to perform any surgical or non-surgical treatment on your body.
Safety
When you plan to undergo any surgery you should always keep in mind that it's your body and it's a surgery. We, here always keep your safety a priority and will never recommend you to undergo any such procedure which is not safe for you. We also provide you with a detailed description of the complications which may occur after the surgery during the consultation as it's a surgical procedure so there may be some complications depending on the way your body reacts.
Kayakriti in news
Frequently Asked Questions
If you have flat or small breast and you want to improve your breast and hip contour ratio then you are a good candidate for it. The answer will be best provided after the first consultation with Dr Amit Agarwal.
Acute pain will be there for almost a week which gradually reduces and there will be soreness and swelling which may take up to 3 weeks to subside.
You can join your work and daily routines after a week of the procedure and can start exercising after 3 weeks of it.
Yes, you have to wear it round the clock unless we suggest you to remove it.
This surgery does not affect the ducts or the areas of the breast involved in milk production. Thus, it does not affect the breast feeding.
This surgery does not affect the ducts or the areas of the breast involved in milk production. Thus, it does not affect the breast feeding.
Kayakriti Plastic Surgery & Dental Center
D-43, Near Punjab National Bank, Rajajipuram, Lucknow, Uttar Pradesh - 226017, India
Phone No. +919695940009, +919695940006
Map Location
Social Media Presence