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Hypospadias causes curvature of the penis of varying degrees of severity; it can be noticed at the time of erection. In addition, the disease is characterized by dysplasia of the foreskin - it splits and covers the head of the penis, like a hood. The anomaly is congenital. It has been established that it develops in the middle of the first trimester of pregnancy, when the fetal genitourinary system is formed. Very rarely, hypospadias occurs in female infants.

Around the 8th week of pregnancy, a malfunction occurs in the process of formation of the fetal urethral canal. The posterior wall of the distal urethra is either absent or develops unevenly. In places where these tissues are lacking, a cord of connective tissue called a notochord is formed. The urethral canal appears flattened and split, and its external opening moves proximally. In girls, the urethra splits along the vaginal walls, and the urethra is transferred into the vagina itself.

Hypospadias – the most common defect of the urethra in men. Today's statistics give a figure of 1 case per 150 newborns. Even 40-50 years ago, the statistics were different - the defect was recorded 4 times less often. In approximately 90-95% of cases, the anomaly has light form, in other patients it manifests itself with various complications.

CAUSES

As with all congenital anomalies, it is difficult to clearly name the reason why there is a disruption in the normal process of intrauterine development internal organs person. Developmental disorders begin at the moment of formation of the fetal genital organs. The connective tissue of the cavernous bodies of the penis is distributed unevenly; the future penis itself develops faster than the urethra, which causes its curvature.

Risk factors for developing hypospadias:

• Genetic conditioning– in 10-20% of patients, close male relatives were born with the same defect.
• Bad ecology and consumption of food containing fungicides, pesticides, phthalates, herbicides that disrupt androgen levels and cause point gene mutations.
• Taking hormonal medications by the expectant mother within 12 months before pregnancy.
• The adverse effect of female hormones on the process of formation of the genital organs of the unborn child during pregnancy using the IVF method.
• Hormonal treatment prescribed to a woman to maintain pregnancy in the first and third trimesters.
• Smoking and drinking alcohol, severe stress, nervous overload during pregnancy.
• Defects in the development of androgen receptors, deficiency of certain enzymes and male sex hormones in the fetus, intrauterine infections.
• Multiple pregnancy– in twins, hypospadias occurs 50% more often.

CLASSIFICATION

With hypospadias, not only a lack of internal sections of the urethral canal and stenosis of the existing ones are noted, but also a displacement of its external opening.

The location of the urethra determines the shape of hypospadias:

• Capitate. The exit point of the external urethral canal is located on the head between its apex and the coronary groove. In this case, dysplasia of the foreskin, stenosis of the urethra and slight curvature of the penis are noted.
• Coronal or crown. The urethra is displaced to the edge of the head of the genital organ near the coronary sulcus. The foreskin covers the dorsal surface like a hood. The head takes on a curved shape, the stream of urine is not even, it has a different angle in relation to the penis.
• Stem or penile. The urethra is located on the shaft of the penis. It is significantly curved. When urinating, the patient has to raise the penis to the stomach so that the stream goes down.
• Scrotal or scrotal. The urethra is displaced to the root of the penis, at its transition to the scrotum or directly on the scrotum. The penis is often underdeveloped, displaced or severely curved. The patient can urinate only while sitting.
• Perineal or perineal. The urethra is located in the perineum, near the anus and has the shape of a funnel. The penis is underdeveloped, often covered by folds of the scrotum, reminiscent of the female labia. Sometimes the defect distorts the appearance of the genital organs so much that without additional examinations it is difficult to determine the sex of the newborn.
• Chordata. It is called hypospadias without hypospadias. It is characterized by the presence of internal distortions of the urethra, externally manifested by varying degrees of curvature of the penis. The urethra is in its physiological place - in the middle of the head. The curvature is due to the difference in the length of the urethral canal, which, due to underdevelopment, is shorter than the penis. During an erection, a short urethra does not allow the penis to straighten; it arches and causes severe discomfort to the person.

SYMPTOMS

The main symptom of hypospadias is the abnormal placement of the external opening of the urethra on the male penis, which is displaced to varying degrees proximally.

Typically, patients with capitate hypospadias do not have serious complaints. They occur in more serious forms of the disease, when, due to its underdevelopment, the urethral canal is stenotic, and the urine stream becomes very thin. This causes discomfort when urinating and requires significant strain from the person.

Depending on the severity of the disease, a man cannot urinate in a physiological way for him, standing. He experiences difficulty and is forced to bend the penis up and to the side, or do it while sitting, so that the splashes do not get on his body and clothes.

The penis has a curvature due to the severity of the disease. It clearly manifests itself at the moment of erection. Dysplasia and overhanging of the foreskin head are observed. Adult patients have difficulty intimate life – sexual intercourse is not complete, ejaculation occurs outside the vagina. Sometimes sexual life is not possible at all, the penis is practically in its infancy.

In women, hypospadias is characterized by the location of the external opening of the urethra inside the vagina.

DIAGNOSTICS

Diagnosis of hypospadias is carried out in the first minutes of a child’s life, during an examination of the baby by a neonatologist. At the same time, 70% of children are diagnosed with capitate and coronal forms of hypospadias. In the future, observation by an endocrinologist, urologist, or gynecologist is required.

During the initial examination, the structure of the child’s external genitalia is examined. Namely, the physiological location, shape and size of the external opening of the urethra, as well as the possible curvature of the penis.

When a deficiency is identified, the form of hypospadias, the degree of urethral stenosis, and features of urination disorders are determined. A number of additional procedures and tests are prescribed to identify all the nuances of hypospadias.

Investigations to detect hypospadias:

• Ultrasound of the pelvic organs, bladder and kidneys to identify possible malformations.
• MRI of the pelvic organs.
• DNA analysis to determine the karyotype, which establishes the usefulness of a person’s chromosome set.
• Urethroscopy is the insertion of a special endoscope into the urethra.
• Cystourethrography is the study of the structure of the bladder and urethra using a contrast agent injected through the urethra.
• Urography of the urinary tract and kidneys followed by x-rays, while a contrast agent is administered to the patient intravenously.
• Urofluometry is the determination of important indicators of urination using a special device.
• Sometimes laparoscopy is prescribed to assess the condition of the internal genital organs.

The most difficult variants of hypospadias to diagnose are those in which testicles are not detected in the scrotum. In such cases, the question arises of establishing the exact gender of the child.

TREATMENT

Hypospadias can only be treated surgically. This intervention is of a reconstructive plastic nature. Most often, capitate forms of hypospadias are not operated on at all. An operation to eliminate it is prescribed if possible benefit surgery significantly exceeds the risks of its implementation, and if there is real discomfort when urinating.

Modern medicine prescribes the first operation for a child aged 6-12 months. It is at this age that there is a minimal difference in the ratio of the length and width of the penis and the patient’s postoperative recovery processes go much faster. In addition, during this period, children are not aware of what is happening, which means there is no psychological trauma, fear of surgery and subsequent complexes due to the deficiency.

The main tasks of surgeons when operating on hypospadias:

• correction of the curvature of the penis with excision of scar tissue of the chord;
• restoration of missing sections of the urethral canal;
• correction of the external opening of the urethra - eliminating stenosis and transferring it to the head of the penis;
• giving the genitals the most natural appearance, correcting cosmetic defects of the penis and scrotum.

As a rule, with capitate, coronal and trunk forms of hypospadias all identified tasks are solved in one operation. Some surgeons prefer to perform the operation in 2 stages to prevent the occurrence of fistulas in the urethra. Then, during the first operation, the chord on the posterior surface of the organ is removed and the curvature of the penis is eliminated, and six months later, during a second operation, the urethral canal is recreated.

What you need to know about the operation:

• An advanced technique is that the missing sections of the urethra are created from the prepuce - the skin that covers the head of the penis, or tissue is taken from the back of the penis. This skin contains blood vessels and grows along with the boy's genitals. Before this, the technology was fundamentally different - the skin for implantation was cut off from the vessels, it essentially became “dead”, which caused complications. Moreover, in this case, the growth of the genital organ stopped, which is why operations were performed after 12 years, giving the penis the opportunity to grow to the size of an adult’s organ.
• After the operation, a catheter is inserted into the patient to drain urine and daily dressings are performed. A few days after the swelling of the urethra disappears, the catheter is removed and the patient is discharged from the hospital - he can now urinate on his own. It is necessary to avoid erection and take a number of sedatives for this.
• Repeated consultations with a doctor are necessary 3 months and 1 year after surgery. If nothing bothers the boy, then the next visit to the doctor should be adolescence. During the period of intensive growth of the genital organs, some curvature of the penis may occur, which is easily corrected with a simple re-operation.

COMPLICATIONS

With the introduction of new surgical techniques the risk of complications is minimal and leaves about 1-1.5%. Postoperative complications include the risk of developing fistulas - ulcers in the urethra, stenosis of the urethra, deformation of the penis, loss of sensitivity of the head.

If the operation is not performed in infancy, then an adult male may experience a number of serious complications.

Untreated hypospadias causes the following problems:

• lifelong discomfort associated with abnormal urination;
• serious violations in sex life, up to the complete impossibility of sexual intercourse;
• infertility or inability to conceive a child;
• stagnation of urine due to incomplete emptying of the bladder, leading to inflammation of the kidneys;
• severe depression, neuroses, complex psychological complexes that prevent a person from living and interacting with the outside world.

PREVENTION

Hypospadias is a genetically determined anomaly. Like all diseases of this etiology, hypospadias is almost impossible to predict and prevent. The only thing a pregnant woman can do is constant monitoring by a gynecologist, preventing the development of intrauterine infections of the fetus, management healthy image life, quitting smoking, drinking alcohol, avoiding stress and minimizing hormonal treatments.

PROGNOSIS FOR RECOVERY

Modern methods of operating for hypospadias make it possible to get by with 1-2 stages of surgical intervention. How younger child, the easier the operation is, complications occur extremely rarely, in only 1-1.5% of cases of mild forms of hypospadias. Whereas previously children were operated on only when they reached 12-14 years of age, and up to 18-20 operations were required to eliminate hypospadias. However, complications occurred in 65-70% of cases.

Today the statistics are radically different - complete healing and restoration genitourinary function occurs in 95% of patients who undergo surgical treatment on time.

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At the MedicaMente clinic, the treatment of hypospadias in children is based on individual approach to every patient. Modern technologies and the methods used make it possible to correct hypospadias very successfully. In most cases, the operation is performed in 1 stage. Children admitted to the MedicaMente hospital in Korolev are treated personally by the head physician of the clinic - Ph.D., pediatric urologist-andrologist M.N. Nikitsky.

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Hypospadias: surgery for children at the Medica Mente medical center

The Department of Pediatric Surgery at the MedicaMente Clinic is one of the few in Moscow that performs urological surgeries for hypospadias in children in the first year of their life, almost immediately after birth. The most delicate surgical techniques, the presence in the hospital of special equipment and materials that increase the safety of treatment, make it possible to perform operations on children and infants from 6 months of age, high level training of medical personnel.

Conducted in early age, has minimal impact on the child’s psyche. The child has the opportunity to develop normally physically and psychologically (for example, learn to write while standing). As a rule, he quickly forgets the negative aspects of postoperative treatment, which does not subsequently affect his personal development. Performing hypospadias surgery in boys becomes more and more difficult with age due to the increasing risks of complications (the presence of an erection greatly increases the risks).

Surgery for hypospadias is considered one of the most difficult operations in pediatric urology-andrology. The surgeon's experience plays a huge role in treatment results. After all, it is extremely important to perform hypospadias surgery so that the little patient, after some time, does not end up on the operating table again with the same disease. The complexity of the operation lies in achieving good patency of the urethra, forming an aesthetically beautiful penis, preventing the occurrence of fistulas and various infections after surgery.

At the pediatric surgery clinic in Korolev, surgical interventions for hypospadias in children are performed by an experienced surgical team under the leadership of a candidate of medical sciences, a pediatric surgeon with extensive experience and experience, who has performed many successful operations. In him you will find an attentive specialist who will provide competent consultation before surgery and take care of your child during subsequent treatment.

Hypospadias surgery in boys

Hypospadias surgery performed at the MedicaMente Department of Pediatric Surgery leaves no external scars and is quickly forgotten. Constant medical supervision helps prevent postoperative complications.

Treatment without pain and fear

Parents accompany their children during all procedures, which are carried out using only painless methods. The introductory stage of anesthesia is carried out in the presence of one of the parents. No injections or manipulations until the child falls asleep. Despite the complexity of hypospadias surgery, children easily tolerate surgical treatment and quickly recover from anesthesia

Operations for boys from 6 months

Delicate surgical techniques, the presence of special equipment and materials in the hospital that increase the safety of treatment, a high level of training of medical personnel make it possible to perform operations on children with hypospadias almost immediately after their birth...how to sign up for treatment

No stress and no queues

Fast hospitalization without queues or delays. You will receive treatment at a time convenient for you. For out-of-town patients, it is possible to have surgery performed on the same day of contacting our center. Typically, discharge from the hospital occurs 2-4 days after surgery.

Hypospadias in children: cost of surgery in Korolev

• inpatient accommodation from 1 to 8 days
• anesthesiological aid: anesthesiological apparatus Drager Fabius GS (Germany), anesthetic Sevoran
• implementation of local blockade - Naropin
• all disposable surgical consumables and instruments
• urethral stenting for up to 7-8 days with a Coloplast urethral catheter
• constant telephone communication with the attending physician
• examination any day in the clinic within 60 days after surgery

• preoperative examinations and tests (can be taken at the clinic at your place of residence, at our Center or any commercial clinic)
• diagnosis and treatment of concomitant diseases and their complications

** This is not a public offer agreement. Check the cost of services on the day of your request.

How is the operation performed?

Hypospadias surgeries are usually successful. With the help of modern surgical techniques used in the Medica Mente clinic, it is possible to completely restore the functions of the penis in case of hypospadias in boys and create a sexual organ that in appearance is almost impossible to distinguish from a normally formed one. Most often, one stage is enough to treat hypospadias. But in complex cases, for example, with scrotal or perineal hypospadias, an operation in 2 stages may be required.

Consultation

The patient is referred or independently comes to us for a consultation. You can make an appointment with a pediatric surgeon by calling the numbers listed on the website or using the electronic appointment form on the website. We accept children both from Moscow and the Moscow region, and from other regions of Russia. Patients from other cities can take advantage of a preliminary remote consultation by telephone. Personal cellular telephone Nikitsky M.N. posted on the website. Please note that the answer to the call depends on the daily routine and work schedule of the surgeon. The doctor may be busy with surgery. Please treat this with understanding. After the consultation, the doctor determines the exact diagnosis, treatment tactics and agrees with you on a convenient day and time for the operation. Prescribes the necessary preoperative examination.

Hospitalization

On the appointed day, the patient is admitted to the hospital. Unlike most public hospitals, in the MedicaMente hospital, a child of any age can stay with his parents. The operation is performed on the day of hospitalization. The introductory stage of anesthesia takes place in the presence of one of the parents (until the baby falls asleep).

Hypospadias surgery in boys

The degree of complexity of the operation and the method of surgical treatment depend on the form of hypospadias. The duration of surgical treatment usually ranges from 90 minutes to three hours.

Postoperative period

On average, patients with hypospadias spend 1 to 8 days in the hospital. During this time, doctors closely monitor the baby's health. After surgery, a urethral catheter (a tube passed through the urethra into the bladder) is installed. Most children respond minimally to the presence of a catheter. Over the next 10 days from the date of surgery, the child is recommended to rest in bed. Many mothers ask: “Is the child tied up after hypospadias surgery?” It's up to the parents to choose. Definitely no one will firmly restrain a child to a bed for the whole day! The main thing is to ensure that the baby does not injure himself, first of all, with his hands and does not pull out the catheter. To prevent trauma to the postoperative area, in the first days it is recommended to gently fix the child’s restless hands. On day 10, the catheter is removed. If everything is okay, they are discharged home. At the request of the parents, discharge can be carried out 2-3 days after the operation. In this case, all postoperative manipulations and observation are carried out at the place of residence. In this case, you can always contact the surgeon who operated on you by phone or contact medical Center to resolve any issues that arise.

What you need to know

At the moment, the only method for correcting all forms of hypospadias in boys is surgery. Carrying out surgery for hypospadias at the earliest possible age allows for less trauma to the child’s psyche and achieves a better result. When treating hypospadias surgically, normal urination is completely restored, the genital organ is straightened, and cosmetic correction of the penis and scrotum is performed to eliminate future psychological problems in the child.

1. Method of operation

   Surgery for hypospadias falls into the category of reconstructive plastic surgery. Many different surgeries have been developed to correct hypospadias. What surgical tactics to choose is decided by the surgeon after a face-to-face consultation (based on the form of hypospadias, the patient’s age, anatomical features his genitals).

2. How long does hypospadias surgery take?

   The duration of surgical treatment usually ranges from 90 minutes to three hours, depending on the complexity.

3. Suture after surgery

   The wound is sutured with cosmetic sutures. Correctly and carefully performed surgery allows you to cure hypospadias in children with a good cosmetic effect, subsequently allowing for an almost complete absence of problems in sexual life, including after the period of maturation.

4. Postoperative period

   Over the next 10 days from the date of surgery, the child is recommended to rest in bed. For the entire postoperative period, children are prescribed antibacterial therapy to prevent possible infectious complications.

Our doctors

The consultation is conducted by pediatric doctors and surgeons at the Medica Mente center.

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Successfully conducts comprehensive diagnostics and treatment of andrological and urological diseases in children. To the pediatric urologist, surgeon M.N. Nikitsky receives patients diagnosed with cryptorchidism, spermatocele, phimosis, hydronephrosis, vesicoureteral reflux, enuresis and others. He has a lot of op...

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Surgical treatment of hypospadias and epispadias

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Treatment of hypospadias involves surgery. Only this method can ensure the elimination of the anomaly and the further normal development of the boy’s genital organs. The operation is recommended to be performed between the ages of 8 months and 3 years. In more late period this is fraught with serious psychological problems. When identifying with peers and identifying his own “otherness,” a boy may develop complexes and fears. In addition, untimely surgery can lead to significant physiological changes, for example, curvature of the penis

Treatment of hypospadias with or without concomitant curvature of the penis is surgical. In the past, surgeries to correct hypospadias were performed at a relatively late age - about 3 years. Today, given psychological problems, which hypospadias can cause, as well as the psychological trauma that penile surgery can cause in a child, most surgeons prefer to operate on patients with hypospadias between the ages of 8 and 16 months.

Typically, hypospadias is corrected and the aesthetic/functional shape of the penis is corrected during the same operation. As a rule, there are practically no postoperative complications, and after the operation the genital organ acquires an aesthetic appearance, with completely preserved sexual and reproductive function.

Treatment of hypospadias

• restoration of the missing part of the urethra,
• moving the external opening of the urethra to its normal position,
• straightening the penis,
• full preservation of sexual function in the future,
• giving an aesthetically adequate appearance external genitalia.

About 150 methods of surgical treatment of hypospadias and their modifications have been proposed, and new options for operations for this defect are being developed. The nature of the intervention depends on the severity of the defect. For crown and pericoronal hypospadias, if the anomaly is not accompanied by curvature of the penis and the external opening of the urethra is of sufficient diameter, surgical treatment is not indicated. The very fact of dystopia of the external opening of the urethra is not an indication for surgical intervention. Repeated operations are not advisable to use only for the purpose of removing the external opening to the head of the penis.

Slight dystopia of the external opening of the urethra does not cause disturbances in either the act of urination or sexual function. In cases where these forms of hypospadias are accompanied by curvature of the glans penis, surgery is necessary. If there is a slight curvature of the head, do not rush into correction. The question of indications for surgery should be decided when the patient becomes an adult. This approach is explained by the fact that a slight degree of curvature of the penis that occurs during an erection does not interfere with sexual activity. In some patients with coronal and peri-coronal forms of hypospadias without curvature of the penis, but with a narrowed external opening of the urethra, surgical treatment consists of meatotomy.

The operation is performed under short-term intravenous anesthesia, since local anesthesia is ineffective. The operation is performed at any age immediately after diagnosis. When a narrowing of the external opening is combined with more severe degrees of hypospadias, requiring straightening of the penis, meatoplasty is performed as independent stage in the first year of a child's life. A pronounced narrowing is an indication for this operation during the neonatal period. Early restoration of the act of urination and elimination of obstruction prevent the development of serious complications from the bladder, ureters, and kidneys. After meatoplasty, catheters or drainage tubes should not be left in the urethra, since even a short-term presence of a foreign body in it is accompanied by urethritis, increases tissue swelling, promotes suppuration and secondary scarring of the external opening. As a rule, children urinate on their own within a few hours after surgery. If urination is delayed, analgesic and antispasmodic agents are administered.

Treatment is surgical, performed in three stages.

Stage I - excision of the chord, alignment of the penis and creation of excess skin for plastic surgery of the urethra.

II and III stages- creation of the urethra. The operation begins at 2-3 years of age, the intervals between operations are 3-6 months.

Treatment of epispadias

The surgical technique for epispadias is similar to the surgical technique for hypospadias, with the only difference being that with epispadias the anterior wall of the urethra is restored

The goal of treatment is to achieve urinary continence (if any), create the missing section of the urethra, and carry out aesthetic correction. Methods for forming the urethra are selected depending on the form of epispadias and the sex of the child. Surgical correction is performed at the age of 4-5 years, when the anatomical prerequisites already exist (the genital organ has reached such a size that it is more convenient to perform surgical interventions on it) and there is still no psychogenic reaction to the disease. The results of surgical treatment at this age are better in terms of functional indicators, for example, the quality of urination (complete emptying of the bladder, no splashing of the urine stream) and the aesthetic condition of the penis.
Correction of deformation of the penile shaft during epispadias requires rather complex surgical treatment in severe forms (plasty of the tunica albuginea of ​​the corpora cavernosa). Shaping the urethra is another challenging task in epispadias correction. The most common operation for epispadias is the Ransley technique. Formation of the urethra from a longitudinal flap, urethral platform and its immersion between the cavernous bodies of the penis. Surgery can improve urinary continence for children with bladder sphincter insufficiency. Provides for comparison and suturing of the glans and plastic surgery of the foreskin. In this case, the skin of the penis, foreskin, skin of the scrotum, and sometimes even a free skin flap of the forearm are used as plastic material.

For complete epispadias, surgical treatment is two-stage. First, the function of the bladder sphincter is restored. The bladder sphincter muscles in complete epispadias are underdeveloped, so even when the integrity of the bladder sphincter is restored, urinary incontinence cannot be stopped in more than half of the patients. In this case, an operation is used to transplant the ureters into the sigmoid colon using an antireflux technique.

A year after restoration of bladder function, the second stage of surgical treatment, urethral plastic surgery, is performed. In this case, the tissue surrounding the canal is used.

Hypospadias in males is a congenital defect that manifests itself during the development of the penis. If there is a deviation in embryonic development the posterior wall of the urinary canal is split in the area from the head to the perineum, and the ventral edge of the preputial sac is split, and the penis takes on a curved shape.

Symptoms and causes of hypospadias

Hypospadias is usually accompanied by the following symptoms:

• urine comes out in another place not intended for this;
• urination occurs more often than usual and is accompanied by difficulty;
• adults find it difficult or impossible to have sexual intercourse;
• the penis is curved.

The causes of the defect are considered to be impaired fetal development at 7-15 weeks, caused by the following factors:

• adverse atmospheric effects: nicotine, alcoholic drinks, incorrectly selected medications, lack of any substances or vitamins in the body;
• frequent hormonal imbalances;
• stressful situations, emotional overload;
• pregnancy with multiple fetuses;
• repeated pregnancies of the mother;
• infectious infection of the fetus inside the womb;
• genetic predisposition.

There is scientific evidence indicating a relationship between pregnancy disorders and the development of hypospadias in boys. Toxicosis and nephropathy increases the risk of fetal urethral cleft in fetal development.

Main types of hypospadias

Capitate hypospadias - with this defect, the urethral opening is located proximal to the head of the penis. The foreskin is often split and the penis is curved. Patients complain about symptoms such as:

• narrowing of the urinary channel;
• reduced urine stream;
• change in the external shape of the penis.

Coronal hypospadias is characterized by the location of the urinary tract in the area of ​​the coronary sulcus. The foreskin is located like a “hood” on the dorsal surface. There is a noticeable curvature of the penis in the ventral direction. Patients complain of a narrowed urethral opening and an angled stream of urine.

Trunk hypospadias is characterized by the location of the urethra on the shaft of the penis. The trunk is more curved than in the coronal or capitate forms. To defecate in a standing position, you need to bend the penis towards the abdominal area.

The scrotal form is characterized by the location of the urinary opening on the scrotum or the space between the scrotum and penis. The penis is strongly curved in the ventral direction, and you can empty yourself only while sitting. The external genitalia of a man with this defect are like enlarged labia and clitoris. In such cases, the help of an endocrinologist is required.

Read also: Is it possible to treat phimosis without circumcision?

Treatment of hypospadias

Treatment for hypospadias is as follows:

• an operation is prescribed to restore the normal location of the urethral opening and eliminate curvature of the penis;
• It is recommended to complete the operation before the child’s personality is formed (up to 6-7 years);
• how older child, the worse the treatment results become. After 10-13 years, the chances of a quick recovery drop rapidly.

In newborns, surgery is best performed before the age of one year: the optimal age is 6 months. If a repeat operation is required, it is recommended to perform it after six months. For adults it all depends individual characteristics body.

Surgery to correct hypospadias is a reconstructive plastic surgery. How long does the operation take? Approximately 1-2 hours depending on the form of the defect. The goals of this operation and how it works:

• the corpora cavernosa straighten and return to their normal position;
• the desired section of the urethra is created, which does not contain fistulas. The formed canal grows along with the child’s penis;
• the external opening of the urinary canal in its normal anatomical position is located on the head and has a longitudinal incision, providing emptying with a direct stream of urine;
• At the end of the operation, aesthetic defects are eliminated as much as possible so that the child can adapt normally to society.

Capitate and coronal forms of hypospadias are carried out in one stage. One operation is enough to ensure normal functionality of the penis and its cosmetic aesthetics. The trunk and scrotal forms take a little longer to treat, as they require more attention and a multi-stage approach.

Such surgical interventions use modern techniques treatment, high-quality suture material (threads are absorbable, sutures do not need to be removed), magnifying devices and microsurgical equipment.

Postoperative period

The postoperative period does not last long. After hypospadias surgery, newborn babies are given a drainage tube that carries urine into the diaper directly from the bladder. Parents should only change their baby's diapers and bring him in for a checkup every few days.