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Hypospadias
Identifying and Treating This Male Genital Anomaly
By Donna Smith
"The reasons to correct hypospadias surgically include functional reasons, as well as cosmetic and potential psychosocial concerns," says Dr. Cheng. He says the two major functional reasons to perform surgery are:
- Downward deflection of the urinary stream that results from the abnormal location of the urethral opening;
- Potential sexual dysfunction later in life related to the downward curvature of the penis.
"Cosmetic concerns are closely linked to potential psychosocial repercussions related to the abnormal appearance of the penis and the child's perception of his genitalia later in life," says Dr. Cheng. "Not all cases of hypospadias require correction. In minor cases where there is no identifiable functional deficit and/or an absence of any cosmetic concerns, one may consider not performing surgical correction."
For mild cases, the hypospadiac defect and associated chordee can be corrected in a one-stage operation on an outpatient basis, says Dr. Cheng. However, in more severe cases, two, if not three or more surgeries may be needed. "The goals of hypospadias surgery are to advance the opening of the urethra to the tip of the penis, which will require the creation of [a] new urethral tube (this is usually done with skin from the penis and/or foreskin), correct the penile curvature and to cosmetically achieve a normal appearing penis," says Dr. Cheng.
While there are many different surgical techniques to fix hypospadias, recent advances in this type of surgery have made it more successful than in the past, says Dr. Cheng. "In cases where the ope
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