Materiały źródłowe

• #1 Hypospadias | Texas Children’s

  https://www.texaschildrens.org/content/conditions/hypospadias

  Hypospadias is a common 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. […] There is no medical management for hypospadias. It must be treated with surgery. In occasional cases where it is determined that the shorter penile length could complicate adequate surgical repair of hypospadias, pre-surgical testosterone injections can be considered. […] The goal of the surgery is both functional — a straight penis with urine hole (urethral meatus) at the end of the penis — and cosmetic. There are many different types of hypospadias surgeries. More severe (proximal) cases sometimes require a 2 stage approach with each stage 6 months apart. With all boys it is advised to perform hypospadias repair between 6-18 months of age.

• #2 Hypospadias Initial Treatment – Adult Center for Reconstructive Urology

  https://centerforreconstructiveurology.org/hypospadias/hypospadias-initial-treatment-adult/

  We initially determine if there is any disabling downward curvature (chordee) that requires correction, and perform a complete urethral evaluation to assess the presence or absence of stricture. Often the urethra can be repaired in one stage using redundant dorsal penile skin as a flap to create a new urethra with an opening at the tip of the penis.[divider] […] In 2003, we began using an innovative technique. Tissue from inside of the cheek (buccal mucosa graft) was used to create a new urethral strip (called the urethral plate). The excess skin from the top (dorsal) part of the penis was then used to complete the repair forming a tube of new urethra composed of both penile skin as a flap and the buccal tissue as a graft. […] Overall, hypospadias surgery can be accomplished with a high success rate and a low complication rate.

• #3 Hypospadias – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/hypospadias/diagnosis-treatment/drc-20355153

  Your child’s pediatrician can diagnose hypospadias based on a physical exam. […] Medical centers with specialty teams can help you look at treatment options and can provide expert treatment. […] But treatment usually involves surgery to put the urethral opening at the tip of the penis. […] Surgery usually takes place between the ages of 6 and 12 months. […] Instead, the foreskin tissue may be left in place for use during surgery to create a penis that looks and works properly. […] In either situation, referral to a pediatric urologist is recommended. […] For most forms of hypospadias, treatment involves a single surgery that’s done on an outpatient basis. […] Some forms of hypospadias require more than one surgery. […] For most men, surgery is highly successful. […] Most of the time the penis looks typical after surgery.

• #4 Hypospadias Repair: Purpose, Procedure, Risks & Recovery

  https://my.clevelandclinic.org/health/treatments/15991-hypospadias-repair

  Hypospadias repair is a surgery that corrects the position of the urethra on your penis. It may be a one- or two-stage procedure, depending on severity. The procedure may take up to two hours to complete. Risks include bruising, infection, swelling, fistulas, and shortening of your penis. Most people fully recover after six weeks. […] A hypospadias repair isn’t always necessary. One of the main objectives of hypospadias repair is to make urinating (peeing) and achieving orgasm (ejaculating) easier and more comfortable. […] A hypospadias repair has a high rate of success. Most repairs last a lifetime, and your child’s penis will function normally and healthily. […] The advantages of hypospadias repair include: Reconstructing your child’s urethra to the tip of their penis to allow for normal peeing and ejaculating.

• #5 Hypospadias Treatment & Management: Approach Considerations, Surgical Care, Complications

  https://emedicine.medscape.com/article/1015227-treatment

  The goals of surgical treatment of hypospadias are as follows: To create a straight penis by repairing any curvature (orthoplasty); To create a urethra that opens at the tip of the penis (urethroplasty) with a natural slitlike configuration (meatus); To re-form the glans into a more natural conical configuration (glansplasty); To achieve cosmetically acceptable penile skin coverage; To create a normal-appearing scrotum. […] The resulting penis should be suitable for future sexual intercourse, should enable the patient to void while standing, and should present an acceptable cosmetic appearance. […] The specific techniques for hypospadias repair are beyond the scope of this article; however, the types of repairs can be generically grouped, and the approach to the repair is relatively standard.

• #6 Hypospadias | Boston Children’s Hospital

  https://www.childrenshospital.org/conditions/hypospadias

  the goals of surgery are usually the same: To reposition the opening of urethra at the tip of the penis (urethroplasty), To straighten the penis, if chordee is present (orthoplasty), To improve the outward appearance of the penis (removing the hooded foreskin). […] Hypospadias surgery typically lasts one to two hours and occurs under general anesthesia.

• #7 Hypospadias – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/hypospadias/symptoms-causes/syc-20355148

  Hypospadias is common and doesn’t cause difficulty in caring for your baby. Surgery usually can create a typical looking penis that works properly. With successful treatment of hypospadias, most men can pass urine properly. And with successful hypospadias treatment, the condition won’t block sperm from fertilizing an egg. […] If hypospadias is not treated, it can result in: […] Problems releasing sperm from the penis. This release is called an ejaculation.

• #8 Hypospadias Treatment & Management: Approach Considerations, Surgical Care, Complications

  https://emedicine.medscape.com/article/1015227-treatment

  The goals of surgical treatment of hypospadias are as follows: To create a straight penis by repairing any curvature (orthoplasty); To create a urethra that opens at the tip of the penis (urethroplasty) with a natural slitlike configuration (meatus); To re-form the glans into a more natural conical configuration (glansplasty); To achieve cosmetically acceptable penile skin coverage; To create a normal-appearing scrotum. […] The resulting penis should be suitable for future sexual intercourse, should enable the patient to void while standing, and should present an acceptable cosmetic appearance. […] The specific techniques for hypospadias repair are beyond the scope of this article; however, the types of repairs can be generically grouped, and the approach to the repair is relatively standard.

• #9 Hypospadias Treatment & Management: Approach Considerations, Surgical Care, Complications

  https://emedicine.medscape.com/article/1015227-treatment

  The treatment for hypospadias is surgical repair. Repair is generally performed for functional and cosmetic reasons. The more proximally ectopic the position of the urethral meatus, the more likely the urinary stream is to be deflected downward, which may necessitate urination in a seated position. Any element of ventral curvature (chordee) can further deflect the urinary stream. The abnormal deflection of ejaculate may preclude effective insemination, and significant chordee can preclude vaginal insertion of the penis or can be associated with inherently painful erections. […] Minor cases of hypospadias, in which the meatus is located distal to the corona on the glans, may not require surgical repair and may simply be managed with observation. It must be kept in mind, however, that although the most minor forms of hypospadias are insignificant in physiologic terms, they too may merit repair on the basis of the potential long-term psychological stress associated with having abnormal genitalia.

• #10 Hypospadias Treatment & Management: Approach Considerations, Surgical Care, Complications

  https://emedicine.medscape.com/article/1015227-treatment

  The treatment for hypospadias is surgical repair. Repair is generally performed for functional and cosmetic reasons. The more proximally ectopic the position of the urethral meatus, the more likely the urinary stream is to be deflected downward, which may necessitate urination in a seated position. Any element of ventral curvature (chordee) can further deflect the urinary stream. The abnormal deflection of ejaculate may preclude effective insemination, and significant chordee can preclude vaginal insertion of the penis or can be associated with inherently painful erections. […] Minor cases of hypospadias, in which the meatus is located distal to the corona on the glans, may not require surgical repair and may simply be managed with observation. It must be kept in mind, however, that although the most minor forms of hypospadias are insignificant in physiologic terms, they too may merit repair on the basis of the potential long-term psychological stress associated with having abnormal genitalia.

• #11 Hypospadias & Chordee | Symptoms, Diagnosis & Treatment

  https://www.cincinnatichildrens.org/health/h/hypospadias-chordee

  Hypospadias is a common structural difference of the penis where the urethra (the tube that carries urine from the bladder to outside of the body) is on the underside rather than the tip of the penis. […] Some patients with hypospadias do not undergo any treatment besides observation, due to no symptoms or patient / family preference. Surgical treatment of hypospadias and chordee can change the appearance of the penis and is desired by some patient / families after discussion with their doctor. […] No medicine will correct a chordee or hypospadias, and the child is not expected to outgrow these anatomical conditions. […] Surgery can often correct hypospadias. The care team may recommend surgery to: Bring the urethral opening to the tip of the penis. This allows a controlled stream of urine while standing.

• #12 Hypospadias | Riley Children’s Health

  https://www.rileychildrens.org/health-info/hypospadias

  Hypospadias is a common condition occurring in 1 out of every 200 live male births. […] For these reasons, it is generally recommended that hypospadias be repaired surgically unless it is extremely mild. […] At Riley at IU Health, our pediatric urologists may work with other specialists through our Disorders of Sexual Differentiation Program to find the best treatment plan for your child. Our team of specialists is ready to support you and your child through diagnosis and treatment. […] Sometimes hypospadias is such a minor issue that treatment is unnecessary. In these cases, your baby boy can be circumcised as any other, if you wish. Even in mild cases, some families choose surgery for cosmetic reasons. […] For more severe hypospadias, surgery is necessary to restore the normal appearance and preserve sexual function of a penis. Our pediatric urologists use established procedures with favorable long-term outcomes for children.

• #13 Hypospadias – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/hypospadias/diagnosis-treatment/drc-20355153

  Your child’s pediatrician can diagnose hypospadias based on a physical exam. […] Medical centers with specialty teams can help you look at treatment options and can provide expert treatment. […] But treatment usually involves surgery to put the urethral opening at the tip of the penis. […] Surgery usually takes place between the ages of 6 and 12 months. […] Instead, the foreskin tissue may be left in place for use during surgery to create a penis that looks and works properly. […] In either situation, referral to a pediatric urologist is recommended. […] For most forms of hypospadias, treatment involves a single surgery that’s done on an outpatient basis. […] Some forms of hypospadias require more than one surgery. […] For most men, surgery is highly successful. […] Most of the time the penis looks typical after surgery.

• #14 Hypospadias: Diagnosis & Treatment | NewYork-Presbyterian

  https://www.nyp.org/pediatrics/urology/hypospadias/treatment

  Hypospadias treatments typically involve surgery, usually performed at 6 to 12 months. Hypospadias surgery can reposition the urethral opening and, if necessary, straighten the shaft of the penis. Minor cases of hypospadias do not require surgery. […] Hypospadias repair aims to reposition the urethra to the tip of the penis and correct any complications of hypospadias. The general steps can include the following: Straightening the shaft of the penis, Constructing a new urethra, Positioning the urethral opening at the tip of the penis, Reconstructing the foreskin. […] Most hypospadias surgeries can be done in a single outpatient procedure. Some forms may require more than one surgery to correct the condition completely. […] Your doctor will prescribe antibiotics to reduce infection risk, and instructions on how to bathe the baby, care for the bandages, and recognize signs of infection or other complications.

• #15

  https://step2.medbullets.com/pediatrics/120602/hypospadias

  A child is born with a urethral opening located between the tip of the glans penis and the base scrotum. […] Treatment […] Medical management […] none […] Surgical intervention […] surgical repair […] indicated in cases proximal (i.e. not adjacent to) from the glands penis […] may not be indicated in less severe cases […] multiple surgical approaches and methodology exist in the literature […] usually performed before 1 year of age […] Complications […] Post-surgical complications, meatal stenosis, urethral strictures/diverticula, recurrent urinary tract infections, permanent phallic malformation […] Prognosis […] Surgical outcomes range, but as surgical technique and microsurgery improves, future prognosis is expected to increase significantly.

• #16 Hypospadias: Causes, diagnosis, and treatment

  https://www.medicalnewstoday.com/articles/hypospadias

  A baby usually receives treatment for hypospadias when they are 6 12 months old. However, treatment is a possibility for children of any age and adults. […] The treatment for hypospadias can depend on the severity of the condition. If a person does not experience any issues due to their hypospadias, they may not require treatment. […] Hypospadias surgery is suitable for people of any age. However, doctors usually perform it on babies aged 6 18 months. […] People who have more severe hypospadias may require surgery, which generally involves four parts: straightening the shaft of the penis if it is curved, making a urinary channel, placing the urethral hole at the tip of the penis, carrying out circumcision or reconstructing the foreskin. […] The surgery for hypospadias generally takes about 1.5 hours for distal hypospadias. Surgery for proximal hypospadias can take up to 3 hours. If a person has proximal hypospadias with severe chordee, they may undergo surgery in stages. […] Treatment should produce favorable functional and cosmetic results. However, certain complications can develop due to the surgery.

• #17 Hypospadias | Children’s Hospital of Philadelphia

  https://www.chop.edu/conditions-diseases/hypospadias

  Surgery to repair hypospadias involves rebuilding the urethra so that it extends into the head of the penis as well as straightening any curvature of the penis. […] If hypospadias repair surgery is indicated, we typically recommend repair between 6 and 18 months of age. This is a time period during which children are less aware of and less interested in their genitalia, which leads to an easier recovery. […] For some patients we recommend one or two pre-operative injections of testosterone to help increase the size of the penis prior to surgery to help improve surgical outcomes. […] There are many different surgical approaches used to correct hypospadias. The method of hypospadias repair depends on the surgeon’s assessment, which includes the location of the meatus, the degree of curvature of the penis, the quality of the penile skin, and whether there has been any prior surgery to the penis.

• #18 Hypospadias in Chattanooga – UT Erlanger Urology

  https://www.uturology.com/conditions-treatments/pediatric-urology/hypospadias/

  Surgery is the only treatment available. Your child will not outgrow this condition. These facts should be considered in making your decision: […] Most pediatric urologists will recommend surgery for all but the most minor problems. […] The vast majority of these surgeries are successful the first time. […] Current thinking is that the best time for surgical correction is between 4- 6 months based on physical, psychological and technical considerations. This has been associated with an improved emotional and psychological result. Later age repair has been associated with complications and significant psychological problems. […] There are a variety of surgical approaches. No single technique is appropriate for all repairs. The surgical choice will depend on the degree of severity and location of the hypospadias. Your UT surgeon will discuss the options with you.

• #19 Hypospadias | Department of Urology

  https://www.med.unc.edu/urology/pediatrics/pediatric-conditions/hypospadias/

  Surgery is required to reposition the urethral opening to the tip of the penis, if necessary straighten the shaft of the penis and correct or remove the dorsal hooded foreskin. […] During surgery, a pediatric urology surgeon uses tissue from the foreskin, the penile shaft, the scrotum and rarely from the inside of the mouth to reconstruct the urethral channel and bring the opening to the tip of the penis. The surgery usually takes from one to four hours and is done while the child is under general anesthesia. If the hypospadias is severe and the penis is severely curved (severe chordee), the repair may require more than one surgery. […] It is best to do surgery between 6 and 18 months. The procedure can be at any age, including into adulthood. […] In most cases, surgical repair results in a penis with a normal or near-normal function and appearance with no immediate or long-term problems. In some cases, a hole (fistula) may develop between the skin and the new urethral channel. This can result in urine leakage and require an additional surgery for repair. Sometimes the opening scars and becomes small (meatal stenosis) after repair resulting in urinary spraying. This requires a minor procedure for repair. […] If your son has hypospadias and requires surgical repair, you may feel worried and anxious. The good news is that the surgery for hypospadias is usually very successful, and your very young child will probably not recall having the procedure.

• #20 Advanced Treatment for Hypospadias: A Comprehensive Guide

  https://drgursev.com/treatment-for-hypospadias-in-adolescence/

  Treatment for hypospadias often requires a multi-disciplinary approach involving pediatric urologists, endocrinologists, psychologists, and other specialists. This ensures comprehensive evaluation, personalized treatment planning, and ongoing support for adolescents and their families throughout the treatment journey. […] While early intervention, typically between 6 months and 2 years of age, is optimal, surgical correction can still be successful in adolescence. Factors like penile growth and hormonal considerations influence the timing of surgery. […] Therefore, adolescents with undiagnosed or untreated hypospadias need to seek immediate medical evaluation and discuss treatment options, including the best timing for surgery.

• #21 Hypospadias repair: MedlinePlus Medical EncyclopediaLock

  https://medlineplus.gov/ency/article/003000.htm

  Hypospadias repair is surgery to correct a defect in the opening of the penis that is present at birth. The urethra (the tube that carries urine from the bladder to outside the body) does not end at the tip of the penis. Instead, it ends on the underside of the penis. In more severe cases, the urethra opens at the middle or bottom of the penis, or in or behind the scrotum. […] Hypospadias repair is done most often when boys are between 6 months and 2 years old. The surgery is done as an outpatient. The child rarely has to spend a night in the hospital. Boys who are born with hypospadias should not be circumcised at birth. The extra tissue of the foreskin may be needed to repair the hypospadias during surgery. […] Before surgery, your child will receive general anesthesia. This will make him sleep and make him unable to feel pain during surgery. Mild defects may be repaired in one procedure. Severe defects may need two or more procedures.

• #22 Hypospadias Treatment & Management: Approach Considerations, Surgical Care, Complications

  https://emedicine.medscape.com/article/1015227-treatment

  The tubularized incised plate (TIP) repair has become the most commonly used repair for both distal and midshaft hypospadias. This technique is a primary tubularization of the urethral plate, with incision of the posterior wall of the plate, which allows it to hinge forward. This creates a lumen of greater diameter than would otherwise be possible, obviating the routine use of a flap or graft to bridge a short narrow segment of urethral plate. […] Various sutures have been used in the repair of hypospadias, but polyglycolic acid-based sutures may offer the best balance of resilience when exposed to urine, without excessive time to absorption resulting in a foreign body reaction. […] Studies support the general concept that increasing the layers of tissue between the urethra and overlying skin coverage makes subsequent development of urethrocutaneous fistula less likely.

• #23 Hypospadias Treatment & Management: Approach Considerations, Surgical Care, Complications

  https://emedicine.medscape.com/article/1015227-treatment

  The tubularized incised plate (TIP) repair has become the most commonly used repair for both distal and midshaft hypospadias. This technique is a primary tubularization of the urethral plate, with incision of the posterior wall of the plate, which allows it to hinge forward. This creates a lumen of greater diameter than would otherwise be possible, obviating the routine use of a flap or graft to bridge a short narrow segment of urethral plate. […] Various sutures have been used in the repair of hypospadias, but polyglycolic acid-based sutures may offer the best balance of resilience when exposed to urine, without excessive time to absorption resulting in a foreign body reaction. […] Studies support the general concept that increasing the layers of tissue between the urethra and overlying skin coverage makes subsequent development of urethrocutaneous fistula less likely.

• #24 Hypospadias Repair Experts | Hypospadias Specialty Center

  https://hypospadias.com/

  Hypospadias Specialty Center is the only practice in North America dedicated to hypospadias care. […] A licensed therapist also works with us to assist parents and patients coping with hypospadias. […] We repair hypospadias virtually every day of the week. […] In fact, Dr. Snodgrass developed the TIP repair, popularly known as the Snodgrass technique, which is the most commonly used operation in the world for hypospadias. […] Dr. Snodgrass and Dr. Bush have dedicated their professional careers to improving hypospadias surgery, especially for the most severe degrees and for reoperations when repairs done by other surgeons did not work. […] They now have among the lowest complications in the world for both distal and proximal hypospadias repairs. […] Dr. Snodgrass and Dr. Bush have identified key factors to ensure success and travel worldwide teaching other surgeons how to improve their results.

• #25 Hypospadias Repair Experts | Hypospadias Specialty Center

  https://hypospadias.com/

  They are using innovative new therapies to increase success in these difficult situations. […] Hypospadias, a penile birth defect of the urinary opening, affects approximately 1 in 200 newborns. Surgery is usually recommended to restore normal appearance and function, and the most common operation performed world-wide is the TIP repair, also known as the Snodgrass procedure. […] Dr. Snodgrass and Dr. Bush have performed more than 2,500 hypospadias operations and reoperations. Their published results are among the best in the world.

• #26 Hypospadias: Causes, Diagnosis and Treatment

  https://www.urology-textbook.com/hypospadias.html

  Urethroplasty is the reconstruction of the missing distal urethra. The surgical techniques described below differ primarily in urethroplasty: application of flaps, incision of the urethral plate or free oral mucosa transplants. […] A second layer of tissue covers the neourethra and prevents the formation of fistulas. A pedicled subcutaneous (dartos) flap is often raised from preputial, penile, or scrotal skin. […] Meatoplasty and glanuloplasty are the reconstruction of the meatus and the glans to achieve a meatus at the tip of the penis with a vertical slit. […] MAGPI is the acronym for Meatal advancement and glanuloplasty (Duckett, 1981b). The MAGPI technique is only suitable for minor distal hypospadias (cosmetic indication). […] TIP urethroplasty is a technique for tubularization of the urethral plate and is suitable for distal to proximal penile hypospadias (Snodgrass, 1994).

• #27 Hypospadias: Causes, Diagnosis and Treatment

  https://www.urology-textbook.com/hypospadias.html

  Urethroplasty is the reconstruction of the missing distal urethra. The surgical techniques described below differ primarily in urethroplasty: application of flaps, incision of the urethral plate or free oral mucosa transplants. […] A second layer of tissue covers the neourethra and prevents the formation of fistulas. A pedicled subcutaneous (dartos) flap is often raised from preputial, penile, or scrotal skin. […] Meatoplasty and glanuloplasty are the reconstruction of the meatus and the glans to achieve a meatus at the tip of the penis with a vertical slit. […] MAGPI is the acronym for Meatal advancement and glanuloplasty (Duckett, 1981b). The MAGPI technique is only suitable for minor distal hypospadias (cosmetic indication). […] TIP urethroplasty is a technique for tubularization of the urethral plate and is suitable for distal to proximal penile hypospadias (Snodgrass, 1994).

• #28 Azthena logo with the word Azthena

  https://www.news-medical.net/health/Hypospadias-Treatments.aspx

  Hypospadias treatment is classified into different types by its location and severity. Midshaft, perineal, penoscrotal, and glanular or distal hypospadias are the major classifications of the disease. […] Surgery is the only possible method, which is dependent on the location and severity of the defect. […] In this stage, the repair is focused on straightening the penile path while defects examined in the degree of curvature are treated next. […] Surgery is done either under the perineum or in the scrotum skin. […] For severe hypospadias, the surgery comprises of dissection of the lining of the penis erectile path. […] The graft can be processed by placing an in-lay next to the hinging mid-line. […] This technique is based on the Thiersh Duplay techniques, with the same procedure as in TIP.

• #29 Hypospadias Treatment & Management: Approach Considerations, Surgical Care, Complications

  https://emedicine.medscape.com/article/1015227-treatment

  Temporary urethral stents are a common adjunct to hypospadias repair and are felt to decrease the likelihood of fistula formation. […] In the setting of repeat repair after unsuccessful surgery for hypospadias when local tissues are unavailable, buccal mucosa has been used for urethral grafting. This tissue is well suited for this purpose because of its availability, characteristics that favor graft success, and resilience to a moist environment. […] Although no corrective medical therapy for hypospadias is known, hormonal therapy has been used as an adjuvant to surgical therapy in infants with exceptionally small phallic size. Preoperative treatment with testosterone or human chorionic gonadotropin (HCG) injection has been used to promote penile growth; some have reported improvement in chordee with lessening in the severity of hypospadias.

• #30 Hypospadias Initial Treatment – Adult Center for Reconstructive Urology

  https://centerforreconstructiveurology.org/hypospadias/hypospadias-initial-treatment-adult/

  We initially determine if there is any disabling downward curvature (chordee) that requires correction, and perform a complete urethral evaluation to assess the presence or absence of stricture. Often the urethra can be repaired in one stage using redundant dorsal penile skin as a flap to create a new urethra with an opening at the tip of the penis.[divider] […] In 2003, we began using an innovative technique. Tissue from inside of the cheek (buccal mucosa graft) was used to create a new urethral strip (called the urethral plate). The excess skin from the top (dorsal) part of the penis was then used to complete the repair forming a tube of new urethra composed of both penile skin as a flap and the buccal tissue as a graft. […] Overall, hypospadias surgery can be accomplished with a high success rate and a low complication rate.

• #31

  https://journals.lww.com/plasreconsurg/fulltext/2000/02000/treatment_modalities_for_hypospadias_cripples.19.aspx

  Hypospadias cripples can be defined as patients with remaining functional complications after previous hypospadias repair. […] The techniques used to solve these problems were circumferential advancement of penile skin, dorsal transposition flap of preputial skin, distally based transposition flap of penile skin, and full-thickness skin graft. […] Between one and nine operations were needed to achieve the desired result (mean and median of two operations). […] The complications after these procedures were 11 fistulas in nine patients, meatal stenosis caused by tight scarring in six patients, and a residual curvature after an orthoplasty that had to be released once before a urethroplasty could be performed. […] Functional complaints that were seen included spraying at micturition (5 patients, 12 percent), dribbling (6 patients, 14 percent), and deviation of urinary stream (7 patients, 16 percent). […] There was no correlation between any functional complaint and the presence of a physical abnormality.

• #32 Hypospadias: Diagnosis & Treatment | NewYork-Presbyterian

  https://www.nyp.org/pediatrics/urology/hypospadias/treatment

  Hypospadias treatments typically involve surgery, usually performed at 6 to 12 months. Hypospadias surgery can reposition the urethral opening and, if necessary, straighten the shaft of the penis. Minor cases of hypospadias do not require surgery. […] Hypospadias repair aims to reposition the urethra to the tip of the penis and correct any complications of hypospadias. The general steps can include the following: Straightening the shaft of the penis, Constructing a new urethra, Positioning the urethral opening at the tip of the penis, Reconstructing the foreskin. […] Most hypospadias surgeries can be done in a single outpatient procedure. Some forms may require more than one surgery to correct the condition completely. […] Your doctor will prescribe antibiotics to reduce infection risk, and instructions on how to bathe the baby, care for the bandages, and recognize signs of infection or other complications.

• #33 Hypospadias

  https://www.upmc.com/services/urology/conditions/hypospadias

  Repair of hypospadias can take many forms, depending on the severity of the deformity. […] The first step of any repair is straightening the penis. Almost all hypospadiac penises will have some degree of curvature that needs to be corrected. Often this can be accomplished simply by „degloving” the penis. This involves making an incision around the skin of the penis just under the coronal groove. […] If degloving the penis does not result in sufficient straightening, further treatment will be needed. These treatment options fall into two general categories: […] A penis with severe curvature that requires grafting on the underside will often be repaired in a staged fashion. The first operation involves straightening the penis as described and transposing most of the foreskin to the underside of the penis for later use in reconstructing the urethra. Approximately six months later, a second operation is performed to create a urethra from the skin on the underside of the penis.

• #34 Hypospadias

  https://www.upmc.com/services/urology/conditions/hypospadias

  If the urethral plate can be preserved, most often UPMC specialists will try to use it as a primary repair to the hypospadias. This results in a urethra that is composed completely of tissue that was originally intended to be urethra, rather than using skin or other materials. This technique also gives a very normal functional and cosmetic result. […] Repair of severe hypospadias or repair after prior failed surgery might require a „free graft” of tissue to rebuild the urethra. This can be skin from the penis, inner arm, or lining of the mouth. Hospitalization is often required after a free graft repair to allow the graft to heal in place with little movement of the area as possible. […] After surgery, a tube is left in the reconstructed urethra in all but the simplest cases. This tube is called a „stent”, and its purpose is to allow free flow of urine while the tissues are healing.

• #35 Hypospadias Repair | Children’s Hospital Pittsburgh

  https://www.chp.edu/our-services/urology/treatment/hypospadias-repair

  Hypospadias is a condition in which the urethra does not develop completely. This results in an opening that is somewhere on the underside of the penis, scrotum or perineum. […] It is for these reasons, as well as the obvious cosmetic defect, that most parents elect to have hypospadias repaired. […] Repair of hypospadias can take many forms, depending on the severity of the deformity. […] Almost all hypospadiac penises will have some degree of curvature that needs to be corrected. […] If degloving the penis does not result in sufficient straightening, further measures will be needed. […] This maneuver almost always requires dividing the urethral plate, the tissue that should have tubularized to form the urethra. […] A penis with severe curvature that requires grafting on the underside will often be repaired in a staged fashion. […] Approximately six months later, a second operation is performed to tubularize a urethra from the skin on the underside of the penis.

• #36 Hypospadias Repair | Children’s Hospital Pittsburgh

  https://www.chp.edu/our-services/urology/treatment/hypospadias-repair

  If the urethral plate can be preserved, most often we will try to tubularize it as a primary repair of the hypospadias. […] The vast majority of these repairs can be performed on an outpatient basis. […] Repair of a severe hypospadias, or a reoperative repair after prior failed surgery, might require a free graft of tissue to rebuild the urethra. […] Hospitalization is often required after a free graft repair to allow the graft to heal in place with as little movement of the area as possible. […] After surgery, a tube is left in the reconstructed urethra in all but the simplest cases. […] The tubes might be in place for as few as two or three days, or as long as two weeks. […] Overall, the results of hypospadias repair are excellent. […] If a fistula should occur, we simply watch it for a period of six months.

• #37 Hypospadias Treatment & Management: Approach Considerations, Surgical Care, Complications

  https://emedicine.medscape.com/article/1015227-treatment

  Temporary urethral stents are a common adjunct to hypospadias repair and are felt to decrease the likelihood of fistula formation. […] In the setting of repeat repair after unsuccessful surgery for hypospadias when local tissues are unavailable, buccal mucosa has been used for urethral grafting. This tissue is well suited for this purpose because of its availability, characteristics that favor graft success, and resilience to a moist environment. […] Although no corrective medical therapy for hypospadias is known, hormonal therapy has been used as an adjuvant to surgical therapy in infants with exceptionally small phallic size. Preoperative treatment with testosterone or human chorionic gonadotropin (HCG) injection has been used to promote penile growth; some have reported improvement in chordee with lessening in the severity of hypospadias.

• #38 Hypospadias Repair | Treatments & Procedures

  https://www.cincinnatichildrens.org/health/h/hypospadias-repair

  Hypospadias is a common problem in which the opening of the penis is on the underside not the tip of the penis. […] Surgical treatment of hypospadias can change the way the penis looks and works. This is desired by some patient/families after one or more visits with their doctor. No medicine will correct hypospadias. Your child will not outgrow this condition. […] Your sons urologist may recommend testosterone shots prior to the surgical repair. Research has suggested that giving this medication before surgery will help to: Increase penis width, Increase penis length, Increase the number of blood vessels. […] This may lead to a larger penis, which may possibly improve the outcome of the surgery. […] Testosterone is a medication that is given as a shot into the body. The testosterone may be ordered by your childs doctor. Your physician will determine the dose given, and how many shots your child will receive.

• #39 Defining the role of pre‐operative hormonal therapy in hypospadias

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9545156/

  In hypospadias surgery, preoperative hormonal therapy (PHT) is primarily used to increase penile dimensions and the vascularity of tissues available for reconstruction, but its use is nonuniform in clinical practice, with no consensus on application or utility. […] PHT is more often indicated for complex cases such as proximal hypospadias, hypospadias with microphallus and hypospadias reoperations. […] While PHT has clear effects on penile morphometry, and more recent controlled trials suggest improved surgical outcomes, the lack of consistent outcome definitions and generally inadequate followup periods continue to consign many of the potential longterm effects of PHT to the unknown. […] The effects of PHT may be utilised to improve outcomes in cases of proximal and severe hypospadias, which under the current paradigm represent a significant surgical challenge.

• #40 Defining the role of pre‐operative hormonal therapy in hypospadias

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9545156/

  Preoperative testosterone has been primarily used to increase penile length, glans width/circumference, inner preputial area, and the vascularity of tissues available for reconstruction in more complex cases such as proximal hypospadias, or hypospadias with coexisting small glans or penis. […] PHT is more often considered when a complex hypospadias repair is anticipated (e.g. in proximal hypospadias, or hypospadias with coexisting small penis/glans (microphallus)). PHT increases penile and glanular size and optimises preputial vascularity; however, these changes may not be sustained. […] Improved vascularity of local tissues may be beneficial to wound healing and aid in achieving a tensionfree repair. […] The reported tissue benefits of PHT suggest the potential to improve surgical outcomes and reduce complications.

• #41 Defining the role of pre‐operative hormonal therapy in hypospadias

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9545156/

  Preoperative testosterone has been primarily used to increase penile length, glans width/circumference, inner preputial area, and the vascularity of tissues available for reconstruction in more complex cases such as proximal hypospadias, or hypospadias with coexisting small glans or penis. […] PHT is more often considered when a complex hypospadias repair is anticipated (e.g. in proximal hypospadias, or hypospadias with coexisting small penis/glans (microphallus)). PHT increases penile and glanular size and optimises preputial vascularity; however, these changes may not be sustained. […] Improved vascularity of local tissues may be beneficial to wound healing and aid in achieving a tensionfree repair. […] The reported tissue benefits of PHT suggest the potential to improve surgical outcomes and reduce complications.

• #42 Hypospadias Treatment & Management: Approach Considerations, Surgical Care, Complications

  https://emedicine.medscape.com/article/1015227-treatment

  One group reported preoperative parenteral testosterone administration to be beneficial in decreasing complication rates (from 13.18% to 5.45%). […] Others, however, have reported increased postoperative complications (including fistula and dehiscence) when testosterone is used, findings that have tempered enthusiasm for this measure.

• #43 Efficacy of preoperative testosterone therapy in hypospadias: a systematic review and meta-analysis | Annals of Pediatric Surgery | Full Text

  https://aops.springeropen.com/articles/10.1186/s43159-021-00117-4

  Preoperative hormone treatment with human chorionic gonadotropin (HCG), dihydrotestosterone (DHT), or testosterone (T) was recommended to improve the surgical result of people having hypospadias correction. […] The rationale for using preoperative androgen is that it will promote vascularization of the prepuce, reducing fibrous tissue growth and inflammation. […] Testosterone was successfully used to increase the breadth of the glans by 4.5mm in proximal hypospadias newborns with small glans, reducing the incidence of issues associated with small glans size. […] According to the study, DHT pretreatment improved penile cosmesis (moderate-to-severe scarring in 2 patients in the treatment group vs. 16 patients in the no-treatment group). […] According to Babu and Chakravarthi, preoperative testosterone significantly increases glans width and reduces difficulties and the necessity for reoperation as well.

• #44 The role of pre-operative androgen stimulation in hypospadias surgery – Kaya – Translational Andrology and Urology

  https://tau.amegroups.org/article/view/5266/6188

  We also considered penile cosmesis to be improved by DHT pretreatment. […] The use of testosterone in male children with a genital defect is not a new concept. […] Many studies have demonstrated that the effect of parenteral testosterone on penile growth and the prepuce up to the day of surgery is significant in the correction of severe cases of hypospadias. […] The only study to characterize the practice patterns of pediatric urologists in the USA revealed that although many of them use testosterone prior to hypospadias repair, their approach remain highly variable. […] The use of testosterone prior to hypospadias repair has been used on patients with microphallic hypospadias or those with a length below what is considered the normal length of a penis of a newborn infant. […] Although many articles on the results of hypospadias surgery have been published, only a few have discussed cosmetic results after the repair.

• #45 Defining the role of pre‐operative hormonal therapy in hypospadias

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9545156/

  Several studies suggest PHT is effective for increasing both stretched and unstretched penile length. […] Overall, studies suggest equivalent results with both IM and topical testosterone for increasing penile length. […] The effect of PHT on penile length and size may not be maintained over time. […] The longterm effects of PHT are poorly studied which has meant some units are cautious when utilising this treatment modality. […] The use of PHT is nonuniform in reported clinical practice, and expert consensus remains elusive. […] Nonetheless, PHT has clear effects on penile morphometry, and more recent controlled trials suggest improved surgical outcomes. Possible indications for treatment include: proximal hypospadias, microphallus and prior to reoperations.

• #46 Hypospadias Treatment & Management: Approach Considerations, Surgical Care, Complications

  https://emedicine.medscape.com/article/1015227-treatment

  One group reported preoperative parenteral testosterone administration to be beneficial in decreasing complication rates (from 13.18% to 5.45%). […] Others, however, have reported increased postoperative complications (including fistula and dehiscence) when testosterone is used, findings that have tempered enthusiasm for this measure.

• #47 The role of pre-operative androgen stimulation in hypospadias surgery – Kaya – Translational Andrology and Urology

  https://tau.amegroups.org/article/view/5266/6188

  The observation of the increased vascularity and therefore the probability of increased intraoperative bleeding in a human skin transplant model with the treatment of human foreskin with testosterone has led to the termination of DHT treatment at least 1 month preoperatively. […] The use of human chorionic gonadotropin and androgens in the management of cryptorchidism and hypospadias provides evidence that hormonal manipulation is often clinically well tolerated. […] Although the previous studies relating to hormonal stimulation have shown an advantage with an increase in penile length and glans circumference, with no significant side effects, there are still some concerns regarding the potential negative side effects such as pubic hair growth and occasional aggressive behavior that reliably resolve with cessation of therapy.

• #48 The role of pre-operative androgen stimulation in hypospadias surgery – Kaya – Translational Andrology and Urology

  https://tau.amegroups.org/article/view/5266/6188

  The desired therapeutic effect of testosterone has been achieved with local and systemic administration in some studies. […] The only well designed, randomized study in the literature has evaluated the efficacy of transdermal DHT on the complications and cosmetic results of primary hypospadias surgery and showed that DHT improves outcomes. […] Despite these limitations, although preoperative hormonal stimulation has been thought to improve surgical results, it is interesting to see that the result of the recent pooled analysis suggests a possible relationship between hormonal use and increased complication rates in patients with severe hypospadias. […] Several studies have shown an advantage with a statistically significant increase in penile length and glans circumference, and an induction of neovascularization.

• #49 Efficacy of preoperative testosterone therapy in hypospadias: a systematic review and meta-analysis | Annals of Pediatric Surgery | Full Text

  https://aops.springeropen.com/articles/10.1186/s43159-021-00117-4

  Studies that did not show a significant difference in penile length found that topical usage was related with more genital pigmentation, pubic hair development, and skin irritation at the application site, suggesting that intramuscular hormone treatment is preferred than topical therapy. […] We discovered a much decrease complication rate for glandular dehiscence in this trial. Reoperation rate, urethral-cutaneous fistula, meatal stenosis, and penile scarring in children with hypospadias, on the other hand, demonstrated that there was no significant difference in the result or side effects in the group receiving testosterone therapy compared to the control group in terms of method of administration (parenteral or topical).

• #50 Hypospadias Treatment & Management: Approach Considerations, Surgical Care, Complications

  https://emedicine.medscape.com/article/1015227-treatment

  Temporary urethral stents are a common adjunct to hypospadias repair and are felt to decrease the likelihood of fistula formation. […] In the setting of repeat repair after unsuccessful surgery for hypospadias when local tissues are unavailable, buccal mucosa has been used for urethral grafting. This tissue is well suited for this purpose because of its availability, characteristics that favor graft success, and resilience to a moist environment. […] Although no corrective medical therapy for hypospadias is known, hormonal therapy has been used as an adjuvant to surgical therapy in infants with exceptionally small phallic size. Preoperative treatment with testosterone or human chorionic gonadotropin (HCG) injection has been used to promote penile growth; some have reported improvement in chordee with lessening in the severity of hypospadias.

• #51 Post-Operative Instructions for Hypospadias Repair | Patient Education | UCSF Benioff Children’s Hospitals

  https://www.ucsfbenioffchildrens.org/education/post-operative-instructions-for-hypospadias-repair

  Children who undergo hypospadias repair are usually discharged from the hospital the same day as the surgery. […] If your child has a catheter, you will be given an antibiotic upon discharge from the hospital. […] Most children will be given a nerve block during surgery to reduce pain. […] Your son will go home with a „dressing” or covering consisting of a clear plastic over gauze, or plain gauze taped around his penis. […] Sponge-bathe your child until the dressing is removed. […] If your son wears diapers, use two diapers for added protection and cushioning. […] Your child can resume a normal diet at home. […] Please encourage quiet play. […] Please call the Pediatric Urology office at (415) 353-2200 to make an appointment to have his catheter removed about one week after the surgery, unless you are instructed otherwise.

• #52 Hypospadias | Texas Children’s

  https://www.texaschildrens.org/content/conditions/hypospadias

  After surgery, your child will usually be discharged home the same day of surgery. He will be prescribed pain medicine for his discomfort, but acetaminophen or ibuprofen is also helpful. Most boys are sent home with a urinary catheter in the penis for a couple of days. He will be prescribed a medication to prevent bladder spasms during this time as well as an antibiotic to prevent infection. […] The most common complication of surgery is an urethrocutaneous fistula, or an opening between the urethra and penile skin. This occurs in about 5% of cases and is most often recognized by the parent seeing 2 separate urinary streams.

• #53 After hypospadias repair | Great Ormond Street Hospital

  https://www.gosh.nhs.uk/conditions-and-treatments/procedures-and-treatments/after-hypospadias-repair-0/

  You should call the ward if: […] After the operation, there will be a flexible plastic tube (catheter) in the urethra with a large dressing covering the penis. Both the catheter and dressing need to be left in place for one week following the operation. […] It is quite normal for your child to feel uncomfortable for a day or two after the operation. […] There is a small risk of infection following surgery so we will give your child a weeks course of antibiotic medicine to take. […] You will need to come back to GOSH one week after the operation so that we can remove the dressing and catheter. […] When the dressing has been removed, your sons penis will look red and swollen. This is normal and will settle down in a week. We will give you some ointment to put on to your sons penis for the next few weeks. This is an antibiotic ointment and will reduce the risk of an infection developing. […] The doctor will see your child for a check-up appointment about three to six months after the operation we will send you details in the post so please make sure we have your correct address.

• #54 Hypospadias Repair – Alder Hey Children’s Hospital Trust

  https://www.alderhey.nhs.uk/conditions/patient-information-leaflets/hypospadias-repair/

  Hypospadias repair involves moving the wee hole to the end of the penis. The repair uses the foreskin to make a new tube inside the penis. This will enable your son to pass urine standing up. […] Hypospadias can be accompanied by Chordee. This causes the penis to have a downward curve, and makes the penis appear shorter. Chordee is caused by a tight band of fibrous tissue which pulls the penis out of shape. This will be corrected as part of the Hypospadias repair surgery. […] Your son will have a stent (small soft tube) placed in his urethra to hold it open, or a catheter inserted into his bladder during the operation. This drains urine so that the new urethra inside his penis can heal. He will have a dressing on after surgery to protect his penis while it heals. […] It is important that your son has lots of drinks while he has a stent or catheter in place. This makes sure there is a good flow of urine through the stent / catheter.

• #55 Post-Operative Instructions for Hypospadias Repair | Patient Education | UCSF Benioff Children’s Hospitals

  https://www.ucsfbenioffchildrens.org/education/post-operative-instructions-for-hypospadias-repair

  Children who undergo hypospadias repair are usually discharged from the hospital the same day as the surgery. […] If your child has a catheter, you will be given an antibiotic upon discharge from the hospital. […] Most children will be given a nerve block during surgery to reduce pain. […] Your son will go home with a „dressing” or covering consisting of a clear plastic over gauze, or plain gauze taped around his penis. […] Sponge-bathe your child until the dressing is removed. […] If your son wears diapers, use two diapers for added protection and cushioning. […] Your child can resume a normal diet at home. […] Please encourage quiet play. […] Please call the Pediatric Urology office at (415) 353-2200 to make an appointment to have his catheter removed about one week after the surgery, unless you are instructed otherwise.

• #56 Hypospadias: Diagnosis & Treatment | NewYork-Presbyterian

  https://www.nyp.org/pediatrics/urology/hypospadias/treatment

  Full recovery from hypospadias surgery can take a few months. You will have a couple of check-ins with the surgeon during this time. After that, it is recommended to visit a pediatric urologist when the child is old enough to start potty training and again during puberty to check for complications. […] The success rate of surgeries for hypospadias is high. In most instances, the penis will heal and appear normal in shape. Your boy will be able to urinate in a straight stream while standing, and it will not affect his ability to reproduce. […] The outcomes of most hypospadias repair surgeries are very successful, resulting in a normal-looking and functioning penis. The corrections generally last a lifetime. […] The Children’s Hospital of New York provides quality care for all types of pediatric urologic conditions, including hypospadias. Once the signs and symptoms of hypospadias are identified, our pediatric specialists will walk you through the treatment options.

• #57 Hypospadias – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/hypospadias/diagnosis-treatment/drc-20355153

  Most men can pass urine properly. […] And with successful hypospadias treatment, the condition won’t block sperm from fertilizing an egg. […] Your child will need a couple of visits to the surgeon after surgery. […] After that, regular follow-up with your child’s pediatric urologist is recommended after toilet training and at puberty to check for healing and possible complications.

• #58 Hypospadias: Diagnosis & Treatment | NewYork-Presbyterian

  https://www.nyp.org/pediatrics/urology/hypospadias/treatment

  Full recovery from hypospadias surgery can take a few months. You will have a couple of check-ins with the surgeon during this time. After that, it is recommended to visit a pediatric urologist when the child is old enough to start potty training and again during puberty to check for complications. […] The success rate of surgeries for hypospadias is high. In most instances, the penis will heal and appear normal in shape. Your boy will be able to urinate in a straight stream while standing, and it will not affect his ability to reproduce. […] The outcomes of most hypospadias repair surgeries are very successful, resulting in a normal-looking and functioning penis. The corrections generally last a lifetime. […] The Children’s Hospital of New York provides quality care for all types of pediatric urologic conditions, including hypospadias. Once the signs and symptoms of hypospadias are identified, our pediatric specialists will walk you through the treatment options.

• #59 Hypospadias repair: MedlinePlus Medical EncyclopediaLock

  https://medlineplus.gov/ency/article/003000.htm

  Surgery is not needed if the condition does not affect normal urination while standing, sexual function, or the deposit of semen. […] Risks for this procedure include: A hole that leaks urine (fistula), Large blood clot (hematoma), Scarring or narrowing of the repaired urethra. […] Right after surgery, your child’s penis may be taped 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 urinary catheter (a tube used to drain urine from the bladder) will be put through the dressing so urine can flow into the diaper. […] Your child will be encouraged to drink fluids so that he will urinate. Urinating will keep pressure from building up in the urethra. […] This surgery lasts a lifetime. Most children do well after this surgery. The penis will look almost or completely normal and function well.

• #60 Hypospadias | Texas Children’s

  https://www.texaschildrens.org/content/conditions/hypospadias

  After surgery, your child will usually be discharged home the same day of surgery. He will be prescribed pain medicine for his discomfort, but acetaminophen or ibuprofen is also helpful. Most boys are sent home with a urinary catheter in the penis for a couple of days. He will be prescribed a medication to prevent bladder spasms during this time as well as an antibiotic to prevent infection. […] The most common complication of surgery is an urethrocutaneous fistula, or an opening between the urethra and penile skin. This occurs in about 5% of cases and is most often recognized by the parent seeing 2 separate urinary streams.

• #61 Hypospadias | Children’s Hospital of Philadelphia

  https://www.chop.edu/conditions-diseases/hypospadias

  Our techniques have been refined over the years to significantly improve the surgical outcomes of our patients with hypospadias. […] The most common complication after hypospadias repair surgery is a leak in the new urethral tube (a urethrocutaneous fistula). The newly created urethral opening can narrow with time, a condition called meatal stenosis. […] Our main focus is to achieve the best outcome for your child, something our surgical team can typically do in one procedure. We continue to seek out innovative techniques to improve surgical outcomes and provide the best results for our hypospadias patients. […] Recent research suggests that long-term follow-up extending into puberty is important for hypospadias patients. […] We have an active research team in place focused on a few core values and goals: Improving surgical outcomes, Psychosocial support, Improving care for hypospadias patients worldwide.

• #62 Hypospadias | Texas Children’s

  https://www.texaschildrens.org/content/conditions/hypospadias

  After surgery, your child will usually be discharged home the same day of surgery. He will be prescribed pain medicine for his discomfort, but acetaminophen or ibuprofen is also helpful. Most boys are sent home with a urinary catheter in the penis for a couple of days. He will be prescribed a medication to prevent bladder spasms during this time as well as an antibiotic to prevent infection. […] The most common complication of surgery is an urethrocutaneous fistula, or an opening between the urethra and penile skin. This occurs in about 5% of cases and is most often recognized by the parent seeing 2 separate urinary streams.

• #63 Hypospadias in Children: Diagnosis and Treatment

  https://www.massgeneral.org/children/hypospadias/diagnosis-and-treatment

  The best treatment for hypospadias is surgery. Hypospadias surgery creates a normal opening of passage of urine (urethral meatus), a straight penis and a normal position of the scrotum in relation to the penis. […] Hypospadias surgery is best performed between 6 months of age and 3 years of age (before your child is toilet trained). This is when the risks of psychologically stressing your child and of using general anesthesia are both low. […] After surgery, your child will be able to drink and eat right away. Minor swelling and pain is normal and can be treated with ibuprofen and acetaminophen at home. Your doctor may also prescribe an antibiotic to prevent bladder spasms. Limit physical activity for your child for the first two weeks after surgery. Following two weeks, they will usually have a post-operative checkup with their doctor and their stitches will be dissolved. […] Both of these complications require a second surgery. Your child must wait at least six months following their hypospadias surgery to allow their tissues to heal before undergoing a second procedure to close fistulas or remove scarring.

• #64 Hypospadias Repair | Children’s Hospital Pittsburgh

  https://www.chp.edu/our-services/urology/treatment/hypospadias-repair

  If the urethral plate can be preserved, most often we will try to tubularize it as a primary repair of the hypospadias. […] The vast majority of these repairs can be performed on an outpatient basis. […] Repair of a severe hypospadias, or a reoperative repair after prior failed surgery, might require a free graft of tissue to rebuild the urethra. […] Hospitalization is often required after a free graft repair to allow the graft to heal in place with as little movement of the area as possible. […] After surgery, a tube is left in the reconstructed urethra in all but the simplest cases. […] The tubes might be in place for as few as two or three days, or as long as two weeks. […] Overall, the results of hypospadias repair are excellent. […] If a fistula should occur, we simply watch it for a period of six months.

• #65 Hypospadias – parent information | CUH

  https://www.cuh.nhs.uk/patient-information/hypospadias-parent-information/

  Your son will need to return to the ward to have the stent removed by a member of the paediatric surgery nurse specialist team between five and ten days after surgery. […] Surgery is undertaken to both give the penis a more normal appearance and to allow the boy to pass urine in a standing position when he is older. […] Complications are not common but include: […] Infection can lead to the hypospadias repair not healing properly (breaking down) and thus further surgery being required. […] A hypospadias fistula is a tiny hole that appears after the operation where the repair has been carried out. […] Your son will be followed up in the outpatient department. The first appointment will take place approximately three to four months after surgery.

• #66 Hypospadias // Middlesex Health

  https://middlesexhealth.org/learning-center/diseases-and-conditions/hypospadias

  Surgery usually can create a typical looking penis that works properly. […] With successful treatment of hypospadias, most men can pass urine properly. […] And with successful hypospadias treatment, the condition won’t block sperm from fertilizing an egg. […] Treatment usually involves surgery to put the urethral opening at the tip of the penis. […] Surgery usually takes place between the ages of 6 and 12 months. […] For most forms of hypospadias, treatment involves a single surgery that’s done on an outpatient basis. […] For most men, surgery is highly successful. […] Most of the time the penis looks typical after surgery. […] And with successful hypospadias treatment, the condition won’t block sperm from fertilizing an egg. […] Your child will need a couple of visits to the surgeon after surgery. […] Regular follow-up with your child’s pediatric urologist is recommended after toilet training and at puberty to check for healing and possible complications.

• #67 Hypospadias: Diagnosis & Treatment | NewYork-Presbyterian

  https://www.nyp.org/pediatrics/urology/hypospadias/treatment

  Full recovery from hypospadias surgery can take a few months. You will have a couple of check-ins with the surgeon during this time. After that, it is recommended to visit a pediatric urologist when the child is old enough to start potty training and again during puberty to check for complications. […] The success rate of surgeries for hypospadias is high. In most instances, the penis will heal and appear normal in shape. Your boy will be able to urinate in a straight stream while standing, and it will not affect his ability to reproduce. […] The outcomes of most hypospadias repair surgeries are very successful, resulting in a normal-looking and functioning penis. The corrections generally last a lifetime. […] The Children’s Hospital of New York provides quality care for all types of pediatric urologic conditions, including hypospadias. Once the signs and symptoms of hypospadias are identified, our pediatric specialists will walk you through the treatment options.

• #68 Hypospadias

  https://www.upmc.com/services/urology/conditions/hypospadias

  Overall, the results of hypospadias repair are excellent. However, it is important to realize that no surgical procedure is perfect and that the results of hypospadias repair cannot be guaranteed. […] Nevertheless, in almost every case, these problems can be dealt with to give a very acceptable result. Some complications that may occur with hypospadias repair include: […] The goal of hypospadias surgery is to provide a penis that is functionally and cosmetically normal. Whether these goals will be met to your satisfaction depends largely on the original anatomy and the tissue available for reconstruction. […] Concerns have been raised, especially on the Internet, about long-term sensation and sexual pleasure in men who have undergone hypospadias repair. The best data indicates that difficulties with erection, sensation, or orgasm are very unlikely to result from hypospadias surgery. […] The Department of Pediatric Urology at UPMC Children’s Hospital of Pittsburgh has pioneered new and simpler techniques for the repair of hypospadias, with excellent results.

• #69 Hypospadias Repair Surgery | Children’s Hospital Pittsburgh

  https://www.chp.edu/our-services/urology/patient-procedures/hypospadias

  Hypospadias repair is a surgery to fix the location of the opening in the penis when it is not in the right place at the end of the penis. […] A pediatric urology doctor, a specialist in surgery of the urinary tracts and reproductive organs of children, will do your child’s hypospadias repair. […] The hypospadias repair surgery will reposition the opening and give the penis a more normal appearance. […] A successful hypospadias repair as a child should last a lifetime, including during periods of rapid penis growth during puberty. […] The surgery to repair it usually involves these steps: Creating the rest of the urethra or tube that did not form to the end of the penis; Moving the opening of the urethra to the end of the penis; Straightening the shaft of the penis if it is curved; and Circumcising (removing) the abnormal foreskin of the penis. […] Some complicated cases of hypospadias may require more extensive surgical repair. […] The caudal anesthesia will allow your child to wake up comfortably, without any pain from the surgery.

• #70 Hypospadias Repair: Purpose, Procedure, Risks & Recovery

  https://my.clevelandclinic.org/health/treatments/15991-hypospadias-repair

  Hypospadias repair is a surgery that corrects the position of the urethra on your penis. It may be a one- or two-stage procedure, depending on severity. The procedure may take up to two hours to complete. Risks include bruising, infection, swelling, fistulas, and shortening of your penis. Most people fully recover after six weeks. […] A hypospadias repair isn’t always necessary. One of the main objectives of hypospadias repair is to make urinating (peeing) and achieving orgasm (ejaculating) easier and more comfortable. […] A hypospadias repair has a high rate of success. Most repairs last a lifetime, and your child’s penis will function normally and healthily. […] The advantages of hypospadias repair include: Reconstructing your child’s urethra to the tip of their penis to allow for normal peeing and ejaculating.

• #71 Hypospadias Repair | Children’s Hospital Pittsburgh

  https://www.chp.edu/our-services/urology/treatment/hypospadias-repair

  The goal of hypospadias surgery is to provide a penis that is functionally and cosmetically normal. […] Minor cosmetic defects can be found after hypospadias surgery, but often these will not be noticeable to the casual observer. […] Repair of hypospadias is a complex surgery and is somewhat different in every case.

• #72 Hypospadias Repair | Children’s Hospital Pittsburgh

  https://www.chp.edu/our-services/urology/treatment/hypospadias-repair

  The goal of hypospadias surgery is to provide a penis that is functionally and cosmetically normal. […] Minor cosmetic defects can be found after hypospadias surgery, but often these will not be noticeable to the casual observer. […] Repair of hypospadias is a complex surgery and is somewhat different in every case.

• #73 Hypospadias

  https://www.upmc.com/services/urology/conditions/hypospadias

  Overall, the results of hypospadias repair are excellent. However, it is important to realize that no surgical procedure is perfect and that the results of hypospadias repair cannot be guaranteed. […] Nevertheless, in almost every case, these problems can be dealt with to give a very acceptable result. Some complications that may occur with hypospadias repair include: […] The goal of hypospadias surgery is to provide a penis that is functionally and cosmetically normal. Whether these goals will be met to your satisfaction depends largely on the original anatomy and the tissue available for reconstruction. […] Concerns have been raised, especially on the Internet, about long-term sensation and sexual pleasure in men who have undergone hypospadias repair. The best data indicates that difficulties with erection, sensation, or orgasm are very unlikely to result from hypospadias surgery. […] The Department of Pediatric Urology at UPMC Children’s Hospital of Pittsburgh has pioneered new and simpler techniques for the repair of hypospadias, with excellent results.

• #74 Hypospadias – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/hypospadias/diagnosis-treatment/drc-20355153

  Your child’s pediatrician can diagnose hypospadias based on a physical exam. […] Medical centers with specialty teams can help you look at treatment options and can provide expert treatment. […] But treatment usually involves surgery to put the urethral opening at the tip of the penis. […] Surgery usually takes place between the ages of 6 and 12 months. […] Instead, the foreskin tissue may be left in place for use during surgery to create a penis that looks and works properly. […] In either situation, referral to a pediatric urologist is recommended. […] For most forms of hypospadias, treatment involves a single surgery that’s done on an outpatient basis. […] Some forms of hypospadias require more than one surgery. […] For most men, surgery is highly successful. […] Most of the time the penis looks typical after surgery.

• #75 Hypospadias – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/hypospadias/diagnosis-treatment/drc-20355153

  Your child’s pediatrician can diagnose hypospadias based on a physical exam. […] Medical centers with specialty teams can help you look at treatment options and can provide expert treatment. […] But treatment usually involves surgery to put the urethral opening at the tip of the penis. […] Surgery usually takes place between the ages of 6 and 12 months. […] Instead, the foreskin tissue may be left in place for use during surgery to create a penis that looks and works properly. […] In either situation, referral to a pediatric urologist is recommended. […] For most forms of hypospadias, treatment involves a single surgery that’s done on an outpatient basis. […] Some forms of hypospadias require more than one surgery. […] For most men, surgery is highly successful. […] Most of the time the penis looks typical after surgery.

• #76 Hypospadias Repair | Children’s Hospital Pittsburgh

  https://www.chp.edu/our-services/urology/treatment/hypospadias-repair

  The goal of hypospadias surgery is to provide a penis that is functionally and cosmetically normal. […] Minor cosmetic defects can be found after hypospadias surgery, but often these will not be noticeable to the casual observer. […] Repair of hypospadias is a complex surgery and is somewhat different in every case.

• #77 Hypospadias Repair Experts | Hypospadias Specialty Center

  https://hypospadias.com/

  Hypospadias Specialty Center is the only practice in North America dedicated to hypospadias care. […] A licensed therapist also works with us to assist parents and patients coping with hypospadias. […] We repair hypospadias virtually every day of the week. […] In fact, Dr. Snodgrass developed the TIP repair, popularly known as the Snodgrass technique, which is the most commonly used operation in the world for hypospadias. […] Dr. Snodgrass and Dr. Bush have dedicated their professional careers to improving hypospadias surgery, especially for the most severe degrees and for reoperations when repairs done by other surgeons did not work. […] They now have among the lowest complications in the world for both distal and proximal hypospadias repairs. […] Dr. Snodgrass and Dr. Bush have identified key factors to ensure success and travel worldwide teaching other surgeons how to improve their results.

• #78 Hypospadias: Practice Essentials, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/1015227-overview

  Hypospadias is an abnormality of anterior urethral and penile development. The urethral opening is ectopically located on the ventral aspect of the penis proximal to the tip of the glans penis, which, in this condition, may be splayed open. […] Modern anesthetic techniques, fine instrumentation, sutures, dressing materials, and antibiotics have improved clinical outcomes and have, in most cases of less severe hypospadias, allowed surgical treatment with a single-stage repair within the first year of life on an outpatient basis. […] With modern anesthetics, instruments, sutures, dressing materials, and antibiotics, hypospadias repair is considered generally successful. […] Although the techniques of hypospadias repair continue to evolve, the broader future of hypospadias treatment is encouraging. Nontraditional tissue adherence techniques have been developed, including tissue glues and laser-activated soldering techniques, but have not been widely adopted. […] Urethral substitutes, which may obviate the difficulties associated with severe hypospadias and poor tissue availability, are currently under investigation.

• #79 Hypospadias: Practice Essentials, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/1015227-overview

  Hypospadias is an abnormality of anterior urethral and penile development. The urethral opening is ectopically located on the ventral aspect of the penis proximal to the tip of the glans penis, which, in this condition, may be splayed open. […] Modern anesthetic techniques, fine instrumentation, sutures, dressing materials, and antibiotics have improved clinical outcomes and have, in most cases of less severe hypospadias, allowed surgical treatment with a single-stage repair within the first year of life on an outpatient basis. […] With modern anesthetics, instruments, sutures, dressing materials, and antibiotics, hypospadias repair is considered generally successful. […] Although the techniques of hypospadias repair continue to evolve, the broader future of hypospadias treatment is encouraging. Nontraditional tissue adherence techniques have been developed, including tissue glues and laser-activated soldering techniques, but have not been widely adopted. […] Urethral substitutes, which may obviate the difficulties associated with severe hypospadias and poor tissue availability, are currently under investigation.

• #80 Hypospadias Repair | DDRC Healthcare

  https://www.ddrc.org/hyperbarics/conditions-can-treat/hypospadias-repair/

  Hyperbaric Oxygen is used as a valuable adjunct in paediatric patients undergoing revision operations for hypospadias. […] At some centres in the world, small clinical trials have shown that HBOT may help outcomes of hypospadias operations, particularly for patients with revision operations. […] For patients having hypospadias surgery the improved oxygen levels at the graft site promotes angiogenesis (new blood vessels to grow) and reduces inflammation, which in turn enables faster healing. […] We receive referrals from paediatric surgeons who are planning surgery for complex hypospadias cases and we typically give 15 sessions of hyperbaric oxygen therapy over 3 weeks (5 before the surgery and 10 after). […] A systematic review and meta-analysis by Chua et al. 2022 showed that adjunct use of hyperbaric oxygen can reduce hypospadias repair failure and complication rates, however higher quality evidence is required. […] There is an established evidence base for the effect of HBO on compromised grafts and flaps and this has formed the basis of utilisation of HBO in hypospadias patients.

• #81 Hypospadias | UM Health-Sparrow

  https://www.uofmhealthsparrow.org/departments-conditions/conditions/hypospadias

  Hypospadias is common and doesn’t cause difficulty in caring for your baby. Surgery usually can create a typical looking penis that works properly. […] With successful treatment of hypospadias, most men can pass urine properly. And with successful hypospadias treatment, the condition won’t block sperm from fertilizing an egg. […] Some forms of hypospadias are very minor and do not need surgery. But treatment usually involves surgery to put the urethral opening at the tip of the penis. If needed, surgery to straighten the shaft of the penis also is done. Surgery usually takes place between the ages of 6 and 12 months. […] For most forms of hypospadias, treatment involves a single surgery that’s done on an outpatient basis. Some forms of hypospadias require more than one surgery. […] For most men, surgery is highly successful. Most of the time the penis looks typical after surgery. Most men can pass urine properly. And with successful hypospadias treatment, the condition won’t block sperm from fertilizing an egg. […] Your child will need a couple of visits to the surgeon after surgery. After that, regular follow-up with your child’s pediatric urologist is recommended after toilet training and at puberty to check for healing and possible complications.

• #82 Hypospadias: Diagnosis & Treatment | NewYork-Presbyterian

  https://www.nyp.org/pediatrics/urology/hypospadias/treatment

  Full recovery from hypospadias surgery can take a few months. You will have a couple of check-ins with the surgeon during this time. After that, it is recommended to visit a pediatric urologist when the child is old enough to start potty training and again during puberty to check for complications. […] The success rate of surgeries for hypospadias is high. In most instances, the penis will heal and appear normal in shape. Your boy will be able to urinate in a straight stream while standing, and it will not affect his ability to reproduce. […] The outcomes of most hypospadias repair surgeries are very successful, resulting in a normal-looking and functioning penis. The corrections generally last a lifetime. […] The Children’s Hospital of New York provides quality care for all types of pediatric urologic conditions, including hypospadias. Once the signs and symptoms of hypospadias are identified, our pediatric specialists will walk you through the treatment options.

• #83 Hypospadias | Riley Children’s Health

  https://www.rileychildrens.org/health-info/hypospadias

  Children who have surgery for hypospadias usually need only one procedure to restore normal anatomy and appearance. Surgery repositions the urethral meatus (pee hole) and straightens the penis. […] The optimal age for your child’s surgery is usually around 9 to 12 months, depending on the severity and type of hypospadias. […] Severe penile anomalies may require surgery in stages to move the urethra, correct the curve of the penis and cover the penis with skin. […] Pediatric urologists at Riley at IU Health are expertly trained to correct this difference. Our team treats 300 to 400 children each year for hypospadias. […] Hypospadias surgery is usually an outpatient surgery and your child should be able to go home the same day. […] Complications are rare, but that often depends on the severity of the condition. Afterwards, your child can lead a normal, healthy life. […] Even the most severe cases of hypospadias are treatable with surgery. […] Boys who have minor hypospadias and those who have surgery to correct it lead normal, healthy lives.

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