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Hypospadias

Hypospadias is a congenital (the baby is born with it) abnormality of the penis that affects about 1 out of every 250 baby boys. The opening of the penis does not come out to the tip. This includes anywhere from an opening just short of the tip to it being located all the way down by the scrotum. Typically there is also a downward bend to the penis. The bend can also vary from very mild to severe. Hypospadias does not affect potty training or urinary control. This is a diagnosis typically discovered on the newborn examination.

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Causes

In most cases we do not know why it occurs. In some cases there is a family history of hypospadias.

Typically hypospadias occurs as an isolated condition. There are no other associated problems. Sometimes hypospadias occurs as one part of a complex syndrome, but those are cases where the baby has multiple problems. In the routine cases there are no concerns about the gender of the baby and normal adult function is expected once successfully repaired.

Our goals are to achieve normal appearance, sexual function and quality of urinary stream. For mild cases, this can be achieved without surgery but the more severe cases will need surgical correction.

Treatment

Surgical repair is ideally performed around the age of 6-12 months old. As the child gets older, the more difficult the recovery can be for both the boy and the parents.

Hypospadias repair

Surgical repair is ideally performed around the age of 6-12 months old. As the child gets older, the more difficult the recovery can be for both the boy and the parents.
Surgery is performed as an outpatient under a general anesthetic. Most cases take between 1.5-3 hours to complete and the baby goes home later that day. In all but the most minor cases, a catheter will be placed and it will stay in to drain the bladder for 5-10 days while the repair heals. We simply let it drip into a diaper.

The mild cases of hypospadias can be repaired with one surgery with a success rate of around 95 percent or greater. And once we have a successful outcome, it is unlikely that there will be problems later in life. The more severe the hypospadias is, the more complex the surgical repair becomes and the risk of complications may increase. In some cases we plan on two surgeries to complete the repair. This is another reason to start repairs at an earlier age.

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