What is hypospadias?

Hypospadias is a common condition that some boys are born with. It happens when the penis does not form completely while the baby is growing in the womb. Specifically, it affects the urethra (the tube that carries urine from the bladder to the outside), the glans (the tip of the penis), and the foreskin.

In a typical penis, the opening where urine comes out is at the very tip. In a boy with hypospadias, this opening (called the meatus) can be found anywhere along the underside of the penis.

What are the different types of hypospadias?

The condition is classified based on where the opening of the urethra is located.

• Mild (Distal): The opening is near the head of the penis. This is the most common form.
• Moderate or Severe (Proximal): The opening is further down the shaft, at the base of the penis, or even near the scrotum (the sac).

Hypospadias also affects the foreskin. It usually does not grow properly on the underside, leading to "extra" skin on the top and very little on the bottom.

Can hypospadias cause other health issues?

Yes, some children may experience other related conditions:

• Chordee: This is when the penis curves, usually downward, during an erection.
• Ventral Curvature: A visible bend in the shaft of the penis.
• Undescended Testicles: When the testicles have not dropped into the scrotum.
• Inguinal Hernias: A bulge in the groin area.

In most cases, however, hypospadias is the only growth issue the baby has at birth.

What causes a child to be born with hypospadias?

Hypospadias is "congenital," meaning the baby is born with it. Between weeks 9 and 12 of pregnancy, male hormones tell the body how to form the penis. During this time, the urethra starts as an open channel and should close into a tube. If this process is interrupted, the opening remains shorter than it should be.

While the exact cause isn't always known, it is likely a combination of genetics and environment. Some risk factors include:

• Use of fertility treatments or assisted reproductive technology (ART).
• The mother taking certain hormones during pregnancy.
• Mothers who are over the age of 35 or are overweight.
• A family history of the condition (fathers or uncles).
• Babies born prematurely or with a low birth weight.

How do you know if a baby has hypospadias?

Common signs that a doctor will look for include:

• The urine opening is not at the tip of the penis.
• A downward curve in the penis shaft.
• A hooded appearance because the foreskin only covers the top half.
• A urine stream that sprays downward rather than straight.

How is it diagnosed?

A doctor might occasionally spot a severe case during a prenatal ultrasound, but most cases are found during a physical exam right after the baby is born. If the penis looks different than expected, a pediatric urologist (a doctor specializing in children’s urinary issues) or a pediatric surgeon will confirm the diagnosis.

How is hypospadias treated?

Surgery is the only way to fix hypospadias. The goal of the surgery is to move the urine opening to the correct spot at the tip, straighten the penis if it is curved, and ensure the scrotum is positioned correctly.

A "distal" repair (near the tip) usually takes about 90 minutes, while a "proximal" repair (further down the shaft) can take up to 3 hours.

What happens during and after the surgery?

During the procedure, the doctor may use a stent (a small tube to keep the new urethra open) or a catheter (a plastic tube to drain urine). This tube usually drains directly into the baby's diaper and is removed by the doctor during a follow-up visit. Antibiotics are often given while the tube is in place to prevent infection.

Important Note on Circumcision: If a baby is born with hypospadias, they should not be circumcised at birth. The doctor will need that extra foreskin tissue to help reconstruct and repair the penis during surgery. After the repair is finished, the penis will usually look as though the child has been circumcised.

When is the best time for surgery?

Doctors usually recommend performing the surgery when the child is between 6 months and 3 years old. This is before the child is toilet trained. At this age, the risks associated with general anesthesia are low, and the child is less likely to experience psychological stress from the procedure.

How long is the hospital stay?

This depends on the severity of the case. Many children go home the same day, while some may stay overnight for observation. Some go home with a catheter, and others do not. You should avoid putting the penis underwater (no tub baths) until the tube is removed, which is typically about a week after surgery.

What are the risks and the recovery process?

Your child can eat and drink normally right after surgery. You can manage mild pain and swelling at home with medications like ibuprofen or acetaminophen. Your doctor may also prescribe an antibiotic or medicine for bladder cramps.

Recovery guidelines:

• Avoid heavy physical activity or "rough play" for two weeks.
• A follow-up visit is usually scheduled for two weeks after surgery to check healing and remove any remaining stitches.

While complications are rare, they are slightly more common in severe cases. These can include:

• Fistula: A small leak or second hole that forms along the shaft.
• Stricture: Scarring that makes the new tube narrow, making it hard to pee.

If you notice urine leaking from a different spot or the pee stream becoming very weak, you should contact your pediatric urologist. If a second surgery is needed to fix these issues, the tissues must heal for at least six months first.

Why choose Tender Palm Super-Speciality Hospital for Hypospadias treatment for children in Lucknow, India?

Tender Palm Super-Speciality Hospital offers advanced Hypospadias treatment for children in Lucknow, India, at an affordable cost. We have a team of experienced pediatric urologists and reconstructive surgeons who provide accurate diagnosis with advanced imaging, personalized medical care, and specialized surgical treatment tailored to each child's specific condition. Our Pediatric Urology team has decades of experience in successfully treating Hypospadias in Lucknow, India.

To seek an Expert Consultation for Hypospadias treatment for children in Lucknow, India:

Call us at +91-9076972161
Email at care@tenderpalm.com

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