While a lot of boys are born with a normal penis that works just fine, others are born with certain congenital malformations of their genitalia. One common condition is penile hypospadias. Other malformations include a wide range of clinical situations such as:
- Hidden penis
- Epispadias with bladder exstrophy
This piece focuses on the surgical treatment of penile hypospadias.
Penile hypospadias reconstruction
Penile hypospadias results in a penis that neither works well or looks normal. The good news is that penile hypospadias can be fixed with surgery. There are several surgical techniques that may be used to fix this problem. The goal of the reconstruction is to create a straight and normal penis with a urinary channel that ends at or near the tip. The procedure takes place in about 90 minutes or double that depending on the complexity and involves 4 main steps:
Step 1. Straightening the shaft
Step 2. Making the urinary channel
Step 3. Positioning the meatus in the head of the penis
Step 4. Circumcising or reconstructing the foreskin
Frequently asked questions about penile hypospadias
Surgeons prefer to do hypospadias in healthy boys who are between 6 and 12 months. However, this repair surgery may also be performed on adults. A successful procedure lasts a lifetime.
How can parents tell whether or not their sons need to see a urologist? Here are some questions to ask:
- Is it mandatory to fix penile hypospadias?
Lots of parents wonder whether surgery is mandatory for mild forms of penile hypospadias. The correction is important because it’s hard to tell what problems may arise in the future. Studies have shown that young boys and men with uncorrected penile hypospadias have lower self-esteem.
So it’s advisable to fix all forms of penile hypospadias. In most cases, the benefit of correction often outweighs the risks.
- What anesthetic is used?
Penile hypospadias repair is performed when the patient is asleep. The surgeon may also use nerve blocks near the penis or in the back to reduce discomfort when the patient wakes up after surgery.
The different forms of anesthesia used are very safe especially when administered by an experienced anesthesiologist who has specialized in taking care of children.
- Which is the best repair option available?
The method that the urologist chooses depends on a couple of factors. These include how curved the penis is and the degree of penile hypospadias.
Sometimes, a simple evaluation doesn’t give the surgeon the full picture. He will know the complete situation when the surgery is underway. This means that a simple distal penile hypospadias repair may turn into a more complex repair.
- How does one take care of the wound?
Penile hypospadias repair wounds don’t take much time to heal and so won’t require so much care. Care has to be taken when bathing to make sure that the wound doesn’t get wet as this could result in an infection. If a catheter is used, it might be required to stay in place for a few days.
- How long does penile hypospadias healing take?
The healing starts as soon as the surgery is done. Pain goes away after a month or so after the bruising and swelling have gone down. However, proper healing may take up to a couple of months.
If there are any complications, recommendations for another surgery aren’t made for another at least 6 months. This allows the tissue ample time to heal completely. Most of the problems have good results the second time.