Hypospadias is a male birth defect in which the opening of the tube that carries urine from the body (urethra) develops abnormally, usually on the underside of the penis. The opening can occur anywhere from just below the end of the penis to the scrotum. In most cases, the cause of this birth defect is not fully understood Treatment with hormones such as progesterone during pregnancy may increase the risk of hypospadias. Certain hormonal fluctuations, such as failure of the fetal testes to produce enough testosterone or the failure of the body to respond to testosterone, increase the risk of hypospadias and other genetic problems.
Mild hypospadias usually does not cause symptoms, especially in newborns and young children. If it's more severe, a male may have problems such as spraying urine, having difficulty directing the urine stream, and having erections that are not straight. In some cases, this defect may make it impossible to urinate while standing.
Hypospadias is usually diagnosed in males at birth. Upon examination, the foreskin is usually incomplete and the urethral opening is misplaced. Mild hypospadias may not be diagnosed unless removal of the foreskin (circumcision) is performed.
Some pediatricians perform ‘partial circumcisions’. In this situation the pediatrician begins the circumcision procedure, and, after exposure of the glans, identifies a hypospadias.
Due to swelling after the procedure, the consequences of a partial circumcision may look bothersome at first, but after several days or weeks the inflammation reduces and the penis appears much better over time.
Male hypospadias is treated for several reasons and is conducted in full term or healthy boys, who are in between 3 months to 18 months. However, the repair can be performed also in childhood and sometimes possibly in the adulthood. Sometimes treatment for testosterone hormone is done before the surgery in case the opening is proximal.
The surgery is done to make the penis to straight to normal position having urinary channel at the head tip ends of the penis. The surgery is performed in four steps.
• Straightening the shaft
• Creation of the urinary channel
• Positioning the opening of the urethral in the head
• Reconstruction or circumcision of the foreskin
The surgery for hypospadias repair takes 90 minutes to 3 hours. It is done usually in stages. The surgery is usually performed with spinal anesthesia or general anesthesia. Urologists perform certain tasks during the surgery. They straighten the shaft separately before the urinary channel is constructed.
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