When parents are told that their baby has hypospadias, it can understandably raise many questions: What is hypospadias? Is it serious? How can I recognize it? Will my child need surgery? And when should treatment be done?
Hypospadias is a congenital condition affecting the penis. It is usually noticed at birth, and early assessment can help parents understand the condition and available treatment options.
Table of Contents
What Is Hypospadias?
Hypospadias is a condition in which the opening through which urine comes out, the urethral opening, is not located at the tip of the penis. Instead, it is positioned somewhere along the underside of the penis.
The exact position can vary. In some children, the opening may be close to the tip, while in others it may be further down the shaft.
Hypospadias can also be associated with a downward curvature of the penis, called chordee, and an unusual appearance of the foreskin.
How Can Parents Recognize Hypospadias?
Hypospadias is often identified by a doctor during the newborn examination, but parents may notice certain features themselves.
Possible signs include:
- The urinary opening is not at the tip of the penis
- The opening appears on the underside of the penis
- The penis appears curved downward
- The foreskin appears incomplete or is mainly present on the upper side of the penis
- The urinary stream may not come straight from the tip
The appearance can vary considerably from one child to another. If parents are unsure about the appearance of their child’s penis, a specialist assessment is appropriate.
What Problems Can Hypospadias Cause?
The effect of hypospadias depends on its severity.
Some children may have relatively minor anatomical changes, while others may experience difficulty directing the urinary stream, significant penile curvature or other functional concerns.
In more pronounced cases, the abnormal position of the urethral opening and curvature may affect urinary function and, later in life, sexual function.
This is why proper assessment is important even when the condition does not initially appear to be causing a problem.
An Important Point About Circumcision
If hypospadias is identified or suspected, parents should seek assessment by a specialist plastic surgeon before circumcision.
Circumcision should generally be deferred until the child has been evaluated because the foreskin may be needed for certain reconstructive techniques.
Parents should therefore have their child assessed by a surgeon experienced in hypospadias repair and pediatric reconstructive surgery before proceeding with circumcision.
When Should Hypospadias Repair Be Performed?
Hypospadias repair should be performed during early childhood, preferably before the age of 5 years.
The exact timing and type of surgery depend on the child’s anatomy, the position of the urethral opening, the degree of curvature and other individual factors.
A specialist assessment helps determine the appropriate surgical plan.
What Is Hypospadias Surgery?
Hypospadias surgery is a reconstructive procedure designed to improve the position and function of the urethral opening and, when necessary, correct penile curvature.
Depending on the child’s anatomy, surgery may involve:
- Reconstructing the urethra
- Bringing the urinary opening towards the appropriate position
- Correcting penile curvature
- Reconstructing the surrounding tissues
Some children can be treated with a single procedure, while more complex cases may require staged reconstruction.
The surgical technique is selected according to the individual child’s condition rather than using the same procedure for every patient.
What Is Recovery Like?
Recovery depends on the type and complexity of the repair.
A urinary catheter or stent may be used temporarily to protect the reconstructed urethra while it heals. Parents receive instructions regarding wound care, medication, bathing and activity.
Regular follow-up is important to monitor healing and urinary function.
Are There Any Risks?
As with any surgical procedure, complications are possible.
These may include infection, bleeding, wound-healing problems, urethral fistula, narrowing of the urinary opening or urethra, or persistent or recurrent curvature.
Some children may require an additional procedure depending on healing and the complexity of the original repair.
Hypospadias Surgery in Peshawar
Dr. Umama Jelani is a Consultant Plastic & Reconstructive Surgeon in Peshawar. Assessment can help determine the severity of hypospadias and whether surgical repair is required.
Early specialist evaluation is particularly important when hypospadias is suspected, as circumcision may need to be deferred until the child has been assessed.
The appropriate treatment and reconstructive approach should be discussed with the parents after evaluating the child’s individual anatomy.
