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Hypospadias repair is a surgical technique that is undertaken to rectify a problem known as hypospadias where the opening in the urethra, the duct through which urine leaves the body, is not positioned at the top of the penis but at the centre towards the bottom. This problem is present at birth and ranges from mild to severe depending on the distance of the external urethral meatus from the top of the penis where its found in-between the shaft, its base or even within the scrotum.

Purpose and Goals of Hypospadias Repair

In terms of outlining the procedure for hypospadias repair, three main objectives are usually enunciated, namely:

Place the urethral opening in its appropriate manner

The surgical procedure repositions the urinary meatus from the centre of the shaft to the top of the penis where it is supposed to be normally.

In case all this is required

In addition to averting functional issues with the urinary and reproductive systems as well as appearance concerns, many boys with hypospadias have also associated chordee or downward curvature of the penis. This includement of correction of penoscrotal hypospadias often involves radial urethroplasty to straighten the penis form.

Permit urine to flow freely

Also, by the reconstruction of the urinary meatus, the urinary stream is effectively directed and satisfactory and does not promote urinary tract infection

Cosmetic enhancement

The surgery aims to ensure that a person’s penis is in a more normative shape to help the individual psychologically and socially.

Surgical Operation

Ptosis correction is mostly performed by a pediatric urologist who is focused on surgical treatment of the urinary tract and genital system in children. The procedure is usually done at a very young age, that is, 6 to 18 months, although it can be done later on if need be.

The surgery is done under general anaesthesia meaning the child is sleeping throughout the procedure and feels no pain. The various surgical steps can be performed differently depending on the degree of hypospadias but in general may include.

 

Straightening of the penis

In case of a chordee deformity, the penis is first straightened by releasing fibrous cords which are creating such bends or curves.

Placing the urethral opening

The new urethra opening is situated at the tip of the penis, and the surgeon makes sure it works normally after placing it.

Discover
Reconstructing the urethra

The new portion of the urethra is constructed with either the skin from the foreskin or the inside of the mouth. This repositioned urethra can now be directed towards the end of the penis, where it would usually be located.

Closing the incisions procedure

When the reconstruction is done, the surgeon at some point or other, ensures that the performed incision is closed with the help of absorbable sutures. Sometimes, it may be implied that a catheter is inserted in the urethra to help ascertain the cure of the disease and to act as a urinary diversion while the surrounding tissues heal.

Postoperative Care

There are cases where, right after the surgery, children become hospitalized for a little while to be monitored. All patients must receive adequate pain relief after surgery and such medication is administered to put the child at ease.

This is done to prevent the new urethra from being strained and therefore, urine is directed through a catheter which is placed for some days. Parents receive detailed instructions on how to take care of the catheter and the surgical area at home. It is necessary to have appointments with the surgeon to mitigate the healing process and confirm that the repair is working appropriately.

Risks and Complications

Surgical procedures infection treatment, and hypospadias surgery bring some risks like any surgical procedure, for example, bleeding, postoperative infection and allergic reactions to anaesthesia. Some common hypospadias surgery complications could be

 

Fistula creation

This is the formation of hypospadias surgery where there is an abnormality in the newly created urethra at the skin connection,

Urethral stricture

This is an anatomic narrowing of the urethra which gives rise to difficulty in passing urine and may need additional treatment.

Recurrence of chordee

Recurrence of chordee

Studies report

however, that the hypospadia repair success rate is generally high, and the functional and cosmetic outcomes for most children are favourable.

Long-Term Outcomes

Rarely, children who had the surgical repair of congenital hypospadias will ever suffer from any urinary or sexual dysfunction. The surgery gives the patient a penis that looks and functions like a normal age-suitable penis, hence the apprehensions of the emotional and physical complications of untreated hypospadias will never be realized. Routine follow-up with a urologist is important as this ensures that the repair is successful and additional problems do not develop as the child grows.

In conclusion, hypospadias repair surgery is aimed mostly at treating the physical as well as psychosocial morbidities so that the affected boys can lead a productive and healthy life.

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