Hypospadias And Its Management!

Hypospadias is a condition or a structural defect of the penis in which the urethra does not open at the tip of the penis. Instead, it is located on the underside between the penis and scrotum. It is a very common genital birth defects in boys. Sometimes, along with Hypospadias, chordee occurs, which is the downward curvature of the penis. Also, cryptorchidism or undescended testicles (a condition in which the testicles are not properly located inside scrotum sac) might occur along with Hypospadias.

Types of Hypospadias-

Based on the location of the urethra, Hypospadias can be categorized into four major types:

· Distal Hypospadias occurs when the urethra is located near the head of the penis.

· Midshaft Hypospadias occurs when the urethra is found between the middle and lower shaft of the penis.

· Penoscrotal Hypospadias occur when the urethra is located at the junction of scrotum and penis.

Perineal Hypospadias is a rare and very severe form of the condition in which the urethra is located behind the scrotum.

Causes of Hypospadias-

While it is unknown what exactly causes Hypospadias, many factors might be involved in the development of this condition, for example, environment, hormones, genes, premature birth, and the health of the mother. It is a congenital condition. This means that it occurs during the development of the fetus inside the mother’s womb.

Symptoms-

Hypospadias is generally not a painful condition. An occurrence of Hypospadias can be identified just by physical examination. Mostly, it is noticed at the time of birth itself. Other indications include the following:

· A downward spray of urine;

· Chordee, or the downward curvature of the penis;

· A hooded penis due to the accumulation of extra foreskin on top;

· The tip of the penis looking abnormal.

In severe cases, this condition can even be diagnosed even through fetal ultrasound prior to birth.

Possible Complications-

If the condition is mild, it does not cause problems. However, if a severe case of Hypospadias is left untreated, it might lead to a number of problems later in life. The urine stream might be thin and downward. The curvature of the penis may lead to sexual dysfunction due to improper alignment. Also, issues related to fertility may also arise. There might be a problem directing the penis for sexual intercourse.

Sometimes, in cases of mild Hypospadias, surgery is performed purely for cosmetic correction.

Surgical Treatment-

There is no medicine to treat Hypospadias which is essentially a structural defect. An expert Pediatric Surgeon might recommend surgical correction between the ages of six months and two years. However, surgery can be performed later than this age too. When the condition is severe, there is a possibility that the surgery is performed in multiple stages. The goal of the surgery for Hypospadias is to ensure that the penis performs well for sexual and urinary functions.

The corrective surgery for Hypospadias is performed under general anesthesia. For the purpose of recovery, urethral catheter is used to drain out urine for the first few days soon after the procedure. The penis is dressed to prevent swelling. Antibiotics help in preventing potential infections.

The surgery for Hypospadias has a high rate of success and very fewer complications.

TAKE HOME MESSAGE:

Hypospadias is a structural defect of the genitalia of human males in which urethral opening is not positioned correctly on the tip of the penis. This leads to an uncontrolled stream of urine and sexual dysfunction. Corrective surgery for treating Hypospadias is the only available option having a high success rate.