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1. Highly Advanced Male Hypospadias Treatment at World
Class Hospitals in India
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2. Highly Advanced Male Hypospadias Treatment at World
Class Hospitals in India
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What is Hypospadias?
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It is a relatively uncommon disorder of the external genitalia
(3:1000 births), that involves incomplete closure of the urethral
groove on the underside of the penis. Normally, the penis serves
a dual role in males by providing a pathway for urine to exit the
bladder and for semen to enter the vagina. Both tasks are
facilitated when the urethral opening (meatus) is positioned
normally at the tip of the head (glans) of the penis.
A genetic cause or an altered synthesis of testosterone (or its derivative) and/or an
anomaly of the receptors for this hormone can be responsible for this condition.
The condition is detected at birth during the complete physical examination of the new
born. The foreskin does not cover the tip of the penis completely and the opening of
urethra can be located anywhere on the underside of the penis from the tip to the
base. About 8 percent of boys with Hypospadias also have a testicle that is not fully
descended into the scrotum. There may be other congenital abnormalities associated
with this condition.

3. Treatment for Male Hypospadias
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For a variety of reasons doctors prefer to do hypospadias surgery
in full-term and otherwise healthy boys, between the ages of
three and 18 months. Yet the repair can be corrected at any age
in childhood and even into adulthood. Occasionally, when the
opening is proximal, treatment with the male hormone
testosterone prior to surgery may be recommended.
The goal of the surgery is to create a normal straight penis with
a urinary channel that ends at the tip of the head of the penis.
The operation usually involves four steps: straightening the
shaft; creating the urinary channel; positioning the urethral
opening in the head and either circumcising or reconstructing the
foreskin.
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Hypospadias repair is usually accomplished in a ninety-minute (distal) to three-hour
(proximal) same-day surgery. In a few instances, however, it is done in stages,
usually when a paediatric urologist wants to separately straighten the shaft before
constructing the urinary channel. It can be done under general anaesthesia or spinal
anaesthesia.

4. Treatment for Male Hypospadias
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First degree hypospadias are primarily a cosmetic defect and have little effect on
function except for direction of the urinary stream. If uncorrected, a second or third
degree hypospadias can make urination messy, necessitate that it be performed
sitting, impair delivery of semen into the vagina (possibly creating problems with
fertility), or interfere with erections. In developed countries, most hypospadias are
surgically repaired in infancy. Surgical repair of first and second degree hypospadias is
nearly always successful in one procedure, usually performed in the first year of life by
a pediatric urologist or a plastic surgeon.
If the penis is small, testosterone or human chorionic gonadotropin (hCG) injections
may be given to enlarge it before surgery.
Surgical repair of severe hypospadias may require multiple procedures and mucosal
grafting. Circumcision should be avoided before repair.
Many surgeons prefer that their patient not urinate through the fresh repair during
the first few days after surgery. So they leave a small catheter in the penis that
drains into the diaper. Antibiotics, and sometimes bladder antispasmodics, are given
while the catheter is in use.
Follow up visit schedule depends on the urologist. Complications like pain, bleeding
and opening of sutures can be seen after the surgery

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