Hypospadias repair . It is surgery to correct a birth defect in males in which the urethra (the tube that carries urine from the bladder to the outside of the body ) does not end at the tip of the penis, but rather on the underside. In the most severe cases, the urethra has the opening in the middle or at the base of the penis or even behind the scrotum .
Summary
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- 1 Description
- 2 Indications
- 3 Risks
- 4 Before the procedure
- 5 After the procedure
- 6 Expectations after surgery
- 7 Convalescence
- 8 See also:
- 9 Sources
Description
Hypospadias repair is usually done when children are between 6 months and 2 years old and is performed on an outpatient basis. On rare occasions it requires hospitalization from one day to the next.
Children born with hypospadias do not undergo circumcision at birth, so their foreskin can be used for repair during surgery . Before surgery, your child will have general anesthesia, which will make him unconscious and unable to feel pain during the operation. Minor defects can be repaired in one procedure, while serious defects may require two or more procedures.
The surgeon will use a small piece of foreskin or tissue from another site to create a tube that increases the length of your child’s urethra . Extending the length of the urethra will allow it to empty into the tip of the penis. During surgery, the surgeon may place a catheter (tube) into the urethra to keep it in its new shape. The catheter can be sutured or attached to the head of the penis to hold it in place and will be removed 1 to 2 weeks after surgery . Most sutures (stitches) used during surgery will dissolve on their own and will not need to be removed later.
Indications
Hypospadias is one of the most common birth defects in babies. Surgery is necessary to allow normal urination, to correct deformity of the penis, and to ensure normal sexual function. The repair is usually carried out before the child reaches school age. If the repair is not done, your child may have:
- Problems controlling and directing the urinestream
- A curve in the penisduring erection
- Problems with fertility
Surgery is not needed if the defect does not affect normal urination while standing, sexual function, or semen deposition .
Risks
The risks of any anesthesia are:
- Allergic reactions to medications
- Respiratory problems
The risks of any surgery are:
- Bleeding
- Blood clot
- Infection
Other risks of hypospadias repair:
- A hole that lets urine out(fistula)
- Large blood clot ( hematoma)
- Scarring or narrowing of the repaired urethra
Before the procedure
The surgeon may request a complete medical history and physical examination of the child prior to the procedure. Always tell your pediatrician or nurse:
- What drugsis the child taking?
- Even medications, herbs, and vitamins you have bought without a prescription.
- About any allergiesthe child has to medications , latex , tape, or skin cleansers.
Ask your pediatrician what drugs your child should take even on the day of surgery. On the day of surgery:
- The baby will generally be asked not to eat or eat anything after midnight the night before surgery.
- Give the child any medicine the doctorhas recommended with a small sip of water .
- The doctor or nurse will tell you what time you should arrive for surgery.
- The doctor willverify that the child is healthy enough for the surgery , which means that he should not have any signs of illness . If your child is sick, the surgery may be delayed.
After the procedure
Immediately after surgery, the penis of the child is taped securely to his belly so that it does not move. Often, a bulky dressing or plastic cup is placed over the penis to protect the surgical area. A bladder catheter (a tube used to drain urine from the bladder ) will come out of the dressing to allow urine to flow freely into the diaper. Your child will be encouraged to drink fluids to urinate. Urinating will prevent pressure from building up in the urethra . Your child may be given medicine to relieve pain. You will probably be able to take your child home the same day of surgery. If you live too far from the hospital , you could stay somewhere nearby for the first night.
Expectations after surgery
This surgery lasts a lifetime and most children have a good prognosis after the procedure. Your child’s penis will look and will also function almost or completely normally. If your son has complicated hypospadias, he may need more operations to improve the appearance of the penis or to repair a hole or narrowing in the urethra . Follow-up visits with a urologist (a doctor who specializes in urinary tract treatment and surgery ) may be necessary once your child has healed from the surgery. Sometimes a consultation is needed when boys reach puberty .
Convalescence
Immediately after surgery , the penis is taped to the abdomen for stability, and pain relief medications can be given . The child is encouraged to drink fluids in order to maintain urinary output and thereby avoid pressure on the urethra . After discharge from the hospital , continue drinking plenty of fluids and resulting frequent urination. Vigorous activity should be avoided until complete healing of the surgical repair.
