Introduction
Hypospadias is kind of a common disorder; it is reported that it occurs in every one kid in 200 kids. It is a condition that results in an abnormally urethral opening, also named meatus. The meatus is located at the end of the penis. It is not located at the tip of the penis. Alternatively, the opening may be any place along the underside of the penis.
Over 80 percent of boys with hypospadias have distal hypospadias. In 15 percent of those distal cases, the penis has a downside curve called "chordee." In some cases, it can be in the middle of the penile shaft, the base of the penis, or even within the scrotum. When the meatus opens further down the shaft, curvature occurs in more than 50 percent of patients.
In most cases, hypospadias is the only developmental problem in these infants and does not imply other problems in the urinary system or other organs.
What Is Hypospadias Repair?
Hypospadias repair is a surgical procedure that is indicated to repair hypospadias. Hypospadias is an inherent disorder. The disorders result in an underdeveloped urethra in the penis. In a baby with hypospadias, its meatus forms in a different location. It may form:
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Along the penis shaft called –the midshaft.
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Near the head of the penis is also called –sub-coronal.
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Where their penis and scrotum meet (penoscrotal), the scrotum is the pouch of skin behind the penis that typically contains the testes.
If the child has hypospadias, they may also have a curved penis called chordee and penoscrotal transposition. The child's healthcare provider may need to treat these conditions also.
What Are the Causes of Hypospadias?
The real causes of hypospadias are still unclear, but it is believed that hormonal changes may cause hypospadias. During pregnancy, between the 9th and 12th week, the development of the penis takes place. Due to hormonal imbalance, it gets disturbed and can result in hypospadias.
What Happens During the Hypospadias Repair Procedure?
For the procedure of hypospadias repair, a different team of healthcare providers specializing in children's medicine and surgery is summed. The team includes pediatric urologists, pediatric anesthesiologists, and pediatric nurses. This team has their specific task to perform and make the procedure comfortable and secure for the child.
The pediatric anesthesiologist gives their contribution by sedating the child with the administration of general anesthesia. The child falls asleep and does not feel any pain during the procedure. As the child falls asleep, the pediatric urologist, with the help of a sterile, removes the foreskin. The foreskin forms a tube and attaches it to the child's urethra to make it longer. A longer urethra provided the movement of the meatus to the tip of the penis.
Commonly, the urologist will insert a catheter or stent into the child's urethra as a support for a few days. A catheter is defined as a soft tube made of rubber, silicone, or other material. A catheter helps in healing and maintaining the shape. It also drains the urine. The catheter is placed for up to two weeks after the hypospadias repair.
What Are the Different Stages of Hypospadias Repair?
A hypospadias repair can be classified as a one or two-stage procedure based on severity.
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In Mid Hypospadias - If a patient suffers from mild hypospadias, they usually require only a one-stage hypospadias repair. A one-stage hypospadias repair is only one surgery.
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In Severe Hypospadias - Patients who suffer from penoscrotal or severe hypospadias require a two-stage hypospadias repair. A two-stage procedure is two surgeries that are usually spaced six months apart. During this procedure, the urologist may use skin from the child's mouth to help create their new urethra.
How Is the Prognosis of Hypospadias Repair?
A hypospadias repair has a very high rate of success. Most repairs last a lifetime, and the child's penis will function normally and healthily.
What Are the Advantages of Hypospadias Repair?
The advantages of hypospadias repair include:
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Reconstruction of the urethra towards the tip of the penis. This allows the child to pee normally and improves ejaculation.
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Straightening their penis.
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Appearance gets improved.
What Are the Risks Associated with Hypospadias Repair?
All surgical procedures are associated with some or other risk. Some risks of hypospadias repair include:
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Anesthesia-related problems.
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Delayed wound healing.
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Infection.
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Blood clot (hematoma).
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Bruising.
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Swelling.
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Scaring.
Some of the Risks After Hypospadias Repair May Include:
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Urethrocutaneous Fistula - A urethrocutaneous fistula is defined as a hole that develops in the skin of the penis, and it can be so deep to reach the urethra. A fistula may form months or years after a hypospadias repair. Pee may leak from a fistula.
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Wounds Break Down - Delayed healing of the transplanted skin.
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Urethral Diverticulum - A protrusion in the urethra like a fluid-filled bag.
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Reoccurring Curvature of the Penis - In some cases, the penis may return to its previous curved shape after a procedure.
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Shortening of the Penis - If a child has a hypospadias repair during puberty or post-puberty, their penis may get shorter.
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Urethral Stricture - A narrow urethra can affect how pee flows and create pressure on the kidneys, prostate, bladder, and testicles. Scarring can affect the width of the urethra by narrowing it.
Other Complications After a Hypospadias Repair May Include:
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Weak urine stream or pain while urinating.
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Pain in testicles, sides, or lower back.
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Lumps or hard spots on the penis.
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Discomfort during intercourse.
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Urinary tract infections (UTIs).
Conclusion
Hypospadias is a congenital disability that can be repaired. The process is very safe and secure and has a good prognosis. There is a difference in the severity of the condition, and according to that, the patient may require only one surgery in mild hypospadias and may need more than one in more severe type of hypospadias. If a child is suffering from hypospadias and needs repair, the parents must understand the child's condition, and they can communicate with their healthcare provider. The child's healthcare provider can examine the child and plan the treatment according to the patient's condition.
