Hypospadias Treatment in Patna

Hypospadias is a condition where the opening of the urethra is not at its usual place. Instead of the tip of the penis, the urethra opens on the underside of the penis or way back near the scrotum (a sac-like structure located under the penis that contains the testicles). The urethra is a tube-like structure that carries urine from the bladder and exits your body. 

This condition is diagnosed in male babies at the time of birth. Surgery is the treatment of choice for hypospadias. Surgery usually restores the shape of the penis and the natural placement of the urethral opening. With successful treatment, babies can pass urine.

What Causes Hypospadias?

The exact reason why hypospadias occurs is unknown. In most cases, it is thought to be a combination of several factors that leads to the development of hypospadias.

Hypospadias runs in the family. At around the 9th to 12th week of pregnancy, the urethra and penis start developing. There are several factors related to the mother that influence this development-

• Age of the mother: Women over the age of 40 have a higher chance of delivering a baby with hypospadias
• Obesity in the mother: Mothers carrying extra weight have been seen to deliver boy babies with hypospadias
• Assisted pregnancies: Women who have undergone fertility treatments to get pregnant have a high chance of delivering a baby boy with hypospadias. The progesterone hormone is believed to play a role here.
• Being exposed to pesticides
• Smoking before and during pregnancy

Hypospadias is usually diagnosed at birth. In some infants, it goes unnoticed. If the urethral opening is only slightly displaced, it becomes very difficult to diagnose it. Bening observant while caring for your baby helps in early diagnosis. Contact his pediatrician immediately if you feel something amiss with your baby’s penis.
Hypospadias has the following symptoms-

• Opening of the urethra at some place along the penis other than the tip
• Incompletely formed foreskin: The foreskin is all bundled up at the top and does not extend downwards. This gives a hooded appearance to the penis.
• Chordee: A condition in which the penis is curved downwards.
• Problem with urination: The urine is not passed in a single, straight stream but sprays everywhere.

Undescended Testes: The testes may not get descended into the scrotum during the gestational period. 

Also Read: hydrocele

Hypospadias is diagnosed at birth by physical examination. The doctor will notice the following issues while examining your baby:

• The foreskin is underdeveloped. It looks gathered at the top of the head of the penis and does not extend to the underside. This makes the penis look hooded.
• The foreskin appears to be hiding the abnormal opening of the urethra.
• There appears to be an opening at the normal place in the penis, but the urine comes out from elsewhere.
• The testicles have not descended into the scrotum.

Sometimes, the urethral opening is only slightly displaced, and the foreskin and the shaft of the penis look normal. In such cases, hypospadias goes undetected. 

Hypospadias is a common condition seen in 1 out of every 200 male babies. The treatment for this condition involves surgery. The surgery may vary depending on where the urethral opening is located, but all surgeries aim to create a straight penis with the urethral opening at the tip. Hypospadias surgery in in Patna is usually done under general anesthesia. 

Also Read: Urethral Stricture Disease

Before Surgery: 

• The surgeon will start testosterone injections for your baby with the aim of making the shaft bigger and wider. This helps to determine the degree of curvature. A wider shaft also increases the odds of the surgery’s success.
• The surgeon will advise getting a cystoscopy and urethrogram done These tests help to detect blockages in the urethra. 
• General instructions on when to stop feeding your baby before surgery will be given to you.
• Details about allergies and any medicines being used will also be taken,

During Surgery: 

Hypospadias surgery can be performed by either a pediatric surgeon in in Patna(a surgeon who treats children from birth to adolescence), pediatric urologist (a pediatric doctor specializing in diseases of the urinary tract, urologist (a surgeon specializing in urinary tract diseases), or plastic surgeons (a surgeon specializing in the repair and reconstruction of structural defects in the skin or any other organs of the body. The procedure is done under general anesthesia. Hypospadias surgery can be done by different techniques: 

• Urethroplasty: Once the anesthesia has taken effect, the surgeon will cut your baby’s foreskin. This foreskin is then made into a tube to lengthen the urethra as much as possible. A longer urethra helps the surgeon to move its opening to the tip of the penis.
• Meatoplasty: In this procedure, the surgeon creates a new opening in the urethra and reconstructs the head of the penis (glans) to accommodate the new opening. Once the urethra is reconstructed and the opening has been fixed to the tip, the surgeon will insert a catheter into the urethra. This helps to hold the urethra in place. It is removed 2 weeks after the surgery.
• Scrotoplasty: This is usually performed in cases of penoscrotal hypospadias. Once the opening of the urethra has been shifted to the tip of the penis, the scrotum is repaired and reconstructed.

Once the surgery is completed, the incisions are closed with dissolvable sutures. These sutures dissolve within two weeks.

After Surgery: 

•  Hypospadias surgery is done as an outpatient procedure. Once the baby is stable post the operation, you can take him home. 
• There will be pain and discomfort for a week after surgery. You will be prescribed pain medications for the same.
• A urinary catheter will be kept for 5 to 14 days after the surgery. This catheter is held in place with stitches. These stitches fall off after two weeks. The surgeon will remove the catheter after 2 weeks during the follow-up visit.

• Complete recovery will take 6 weeks. Follow all the instructions regarding postoperative care given to you while being discharged.
• Feed your baby well. This ensures the urine is clear and clean.
• Change the dressing after 2 days. There may be some oozing and spotting on the dressing, which is normal. Once the dressing is removed after 2 to 3 days, the wound is left open to heal.
• Do not apply ointments or powder on the genitals. Keep the area clean and dry.
• You may take your baby for a walk in the stroller but do not allow him to play in the sand or water. If your child is a little older, he should avoid activities like cycling and running

Hypospadias requires early diagnosis and timely surgery. If not, it can create problems later on in life.

• In hypospadias, the penis has a curve. If the curve is severe, it may interfere with getting an erection in adult life.
• Even if the urethral opening is not very much displaced, it may be larger or smaller than normal. Many a time, there is a web of skin at the opening. This causes trouble during urinating. Some boys are not able to urinate in a straight line, while some need to sit down to pee. Some boys find their urine going sideways. All these issues cause huge social embarrassment. The impact of this on the boy’s mental health should not be undermined.
• The foreskin is also underdeveloped in hypospadias. This gives a different appearance to the penis than normal. This can affect the boy mentally and lead to low self-esteem.

Hypospadias can be hereditary, and often, it cannot be prevented. It may help if the mother avoids hormonal therapy during pregnancy and does not expose herself to harsh pesticides like dioxin, DDT, and PCBs. Identifying genetic susceptibility before pregnancy can also help to some extent in preventing hypospadias.

Surgery can be a daunting aspect, and feeling anxious is absolutely normal. The massive amount of information you can get from the internet may confuse you even more. This is where Medfin can help. Leave us the hefty task of finding the best hospital, the finest doctor, and the latest procedure at the lowest cost. Let us take charge while you sit back and focus on your health and recovery. Think surgery! Think Medfin!