What is hypospadias?
Hypospadias is when the child’s urination hole is not at the tip of the penis, but under it. The urinary canal is not fully formed in the area between this hole and the tip of the penis. Hypospadias can be classified differently according to the location of the urinary opening. Cases of hypospadias located in the head of the penis, which are very close to the place where the normal urinary opening should be, are called glandular hypospadias. If it is located at the junction between the head of the penis and the body of the penis, it is called coronal hypospadias. Both conditions are generally included in the definition of “distal hypospadias”, this group is the most common in children and has the highest surgical success rate. There are also hypospadias located lower, the urinary hole can be located anywhere on the body of the penis, in the area where the penis and the bags meet, even in the area we call the perineum close to the anus. Of course, surgical treatment of lower located hypospadias is more difficult.
What are the symptoms of hypospadias?
As I mentioned above, the most important symptom is the opening of the urinary hole to a lower place in the body of the penis, not to the tip of the penis.
Hypospadias is called by different names among the people, the prophet can be called circumcised, congenitally circumcised or half-circumcised. The main reason for these is that the anterior side of the foreskin is not developed in children with hypospadias. The foreskin is located only on the back of the penis.
There may be curvature of the penis, called chord, in the case of erection, which is called erection. The more severe the hypospadias anomaly is, the farther the urethra is from the tip of the penis, the greater the curvature, called chordee. One of the most basic parts of the treatment in hypospadias surgery is the correction of this curvature.
Children with hypospadias prefer to pee sitting up, because they urinate downstream rather than across when peeing standing up.
Is it a congenital condition? How often does it occur?
Hypospadias is a congenital condition. The cause is not known for certain. While there are some studies showing that hormonal stimuli are lacking in the mother’s womb, some studies completely reject them.
The presence of concomitant urogenital system anomalies with hypospadias, especially in severe cases, also supports that it is congenital.
It is one of the most frequently encountered situations in pediatric urology practice. One of every 300 boys has hypospadias. Those with urinary canal near the tip of the penis, which we call distal type hypospadias, are more common.
The diagnosis can be easily made with a careful physical examination when the baby is born.
Should further research be done after a diagnosis of hypospadias?
Along with hypospadias, other urogenital system disorders are more likely to be seen, especially in severe cases. For this reason, in severe cases, especially the urinary system (kidney and urinary drainage channels, and bladder) should be examined. If there is bilateral undescended testis with hypospadias, chromosomal studies should be done to determine whether this is a problem of sexual differentiation.
When should treatment be done?
The only treatment for hypospadias is surgery. It is necessary to avoid painful interventions to the penis between the ages of 2-6, which is called the phallic period, the period when the child discovers his sexual identity. Therefore, hypospadias surgery should be performed without discovering the child’s sexual identity. The care of this surgical intervention during the diaper period is also easier.
Who should perform hypospadias surgery?
There are approximately 500 types of operations defined in the surgical treatment of hypospadias. Everyone claims to be able to perform hypospadias surgery; Plastic surgeons, urologists, pediatric surgeons and even general surgeons. Each branch states that it does this job well. However, the information we have; One out of every three operations performed in inexperienced hands results in complications.
What is done in hypospadias surgery?
The main purpose is to bring the urinary hole called the urethra to the tip of the penis. Commonly asked question; Is the treatment performed with stitches or patches? Both methods are used. Basically, after creating the urinary canal with stitches, placing a patch on it as a layer will strengthen the tissue.
The curvature of the penis must be corrected.
Depending on the weight of hypospadias, circumcision can be performed together with it. Or the foreskin can be used as a patch. However, the opinion expressed by some of our colleagues that surgery and circumcision should not be performed together is not correct. On the contrary, circumcision will save the child from a second operation.
What awaits Baby-Child and Family After Surgery? How long does he stay in the hospital? Does it hang at the end?
Today, pediatric urologists or pediatric surgeons experienced in hypospadias perform hypospadias surgeries as outpatient surgical procedures. In other words, the child will have surgery and can go home the same day. The dressing is opened on the third or fifth day after the operation. On the seventh day, the probe is withdrawn. There is no need to stay in the hospital.
Urinary catheters called stents are necessary for recovery. Babies can be sent home with a catheter using double diapers. In older children, the stent is cut immediately close to the glans penis, and the child can go to the toilet and urinate from the stent.
What are the complications?
As I mentioned above, the complication rate is very high in inexperienced hands. The child or baby should be given the chance to solve this problem with a single operation. The success rate of a penis that has undergone surgery before is less than that of a penis that has never been touched.
The most common complication is fistula development; The urinary hole is moved to the tip of the penis, but sometimes the urine comes from more than one hole due to the opening of the stitches. No intervention can be made until 6 months after this complication develops. However, it is one of the easiest complications to correct.
Complete opening of the sutures, bleeding, development of gangrene on the penile skin can be counted among the other complications.
Stenosis and penile curvature are other important complications.
Hypospadias is when the child’s urination hole is not at the tip of the penis, but under it. The urinary canal is not fully formed in the area between this hole and the tip of the penis. Hypospadias can be classified differently according to the location of the urinary opening. Cases of hypospadias located in the head of the penis, which are very close to the place where the normal urinary opening should be, are called glandular hypospadias. If it is located at the junction between the head of the penis and the body of the penis, it is called coronal hypospadias. Both conditions are generally included in the definition of “distal hypospadias”, this group is the most common in children and has the highest surgical success rate. There are also hypospadias located lower, the urinary hole can be located anywhere on the body of the penis, in the area where the penis and the bags meet, even in the area we call the perineum close to the anus. Of course, surgical treatment of lower located hypospadias is more difficult.
What are the symptoms of hypospadias?
As I mentioned above, the most important symptom is the opening of the urinary hole to a lower place in the body of the penis, not to the tip of the penis.
Hypospadias is called by different names among the people, the prophet can be called circumcised, congenitally circumcised or half-circumcised. The main reason for these is that the anterior side of the foreskin is not developed in children with hypospadias. The foreskin is located only on the back of the penis.
There may be curvature of the penis, called chord, in the case of erection, which is called erection. The more severe the hypospadias anomaly is, the farther the urethra is from the tip of the penis, the greater the curvature, called chordee. One of the most basic parts of the treatment in hypospadias surgery is the correction of this curvature.
Children with hypospadias prefer to pee sitting up, because they urinate downstream rather than across when peeing standing up.
Is it a congenital condition? How often does it occur?
Hypospadias is a congenital condition. The cause is not known for certain. While there are some studies showing that hormonal stimuli are lacking in the mother’s womb, some studies completely reject them.
The presence of concomitant urogenital system anomalies with hypospadias, especially in severe cases, also supports that it is congenital.
It is one of the most frequently encountered situations in pediatric urology practice. One of every 300 boys has hypospadias. Those with urinary canal near the tip of the penis, which we call distal type hypospadias, are more common.
The diagnosis can be easily made with a careful physical examination when the baby is born.
Should further research be done after a diagnosis of hypospadias?
Along with hypospadias, other urogenital system disorders are more likely to be seen, especially in severe cases. For this reason, in severe cases, especially the urinary system (kidney and urinary drainage channels, and bladder) should be examined. If there is bilateral undescended testis with hypospadias, chromosomal studies should be done to determine whether this is a problem of sexual differentiation.
When should treatment be done?
The only treatment for hypospadias is surgery. It is necessary to avoid painful interventions to the penis between the ages of 2-6, which is called the phallic period, the period when the child discovers his sexual identity. Therefore, hypospadias surgery should be performed without discovering the child’s sexual identity. The care of this surgical intervention during the diaper period is also easier.
Who should perform hypospadias surgery?
There are approximately 500 types of operations defined in the surgical treatment of hypospadias. Everyone claims to be able to perform hypospadias surgery; Plastic surgeons, urologists, pediatric surgeons and even general surgeons. Each branch states that it does this job well. However, the information we have; One out of every three operations performed in inexperienced hands results in complications.
What is done in hypospadias surgery?
The main purpose is to bring the urinary hole called the urethra to the tip of the penis. Commonly asked question; Is the treatment performed with stitches or patches? Both methods are used. Basically, after creating the urinary canal with stitches, placing a patch on it as a layer will strengthen the tissue.
The curvature of the penis must be corrected.
Depending on the weight of hypospadias, circumcision can be performed together with it. Or the foreskin can be used as a patch. However, the opinion expressed by some of our colleagues that surgery and circumcision should not be performed together is not correct. On the contrary, circumcision will save the child from a second operation.
What awaits Baby-Child and Family After Surgery? How long does he stay in the hospital? Does it hang at the end?
Today, pediatric urologists or pediatric surgeons experienced in hypospadias perform hypospadias surgeries as outpatient surgical procedures. In other words, the child will have surgery and can go home the same day. The dressing is opened on the third or fifth day after the operation. On the seventh day, the probe is withdrawn. There is no need to stay in the hospital.
Urinary catheters called stents are necessary for recovery. Babies can be sent home with a catheter using double diapers. In older children, the stent is cut immediately close to the glans penis, and the child can go to the toilet and urinate from the stent.
What are the complications?
As I mentioned above, the complication rate is very high in inexperienced hands. The child or baby should be given the chance to solve this problem with a single operation. The success rate of a penis that has undergone surgery before is less than that of a penis that has never been touched.
The most common complication is fistula development; The urinary hole is moved to the tip of the penis, but sometimes the urine comes from more than one hole due to the opening of the stitches. No intervention can be made until 6 months after this complication develops. However, it is one of the easiest complications to correct.
Complete opening of the sutures, bleeding, development of gangrene on the penile skin can be counted among the other complications.
Stenosis and penile curvature are other important complications.
