Pediatric – Hypospadias
Mostly, boys are born with a fully functioning penis. At times, some congenital (birth) disorders can result in a malformed and malfunctioning penis. This can cause extreme disruption in the functioning and use of the penis by the child.
Normally, the penis serves as the channel to excrete urine and ejaculate semen from the body. The normal opening of the urethra (at the tip of the penis), also called the ‘meatus’, needs to be above the glans (head of the penis). Initially, after since birth, the foreskin covers the glans of the penis and cannot be usually pulled back until the child hits puberty.
The development of the penis takes place in the period between weeks 9 and 12 of the pregnancy. In this period, the male hormones stimulate the formation of the foreskin and the urinary channel. A problem in the hormonal action in this period results in malformation of the penis, causing Hypospadias.
This is a common enough birth disorder and is seen in at least 1 out of 2 children. Hypospadias causes limited or abnormal formation of the urethral opening on the tip of the penis. This results in the urethral opening being formed in the portion beneath the glans, causing distal Hypospadias. It may also be positioned mid-way along the penis or even at the base of the penis, causing proximal Hypospadias. This condition often results in mild to severe curvature in the penis.
Hypospadias is normally detected at birth by the abnormal positioning of the urethral opening and the limited development of the foreskin (dorsal hood).
What is the treatment method for Hypospadias?
Surgical correction has been the conventional form of treating Hypospadias from more than two centuries. Today, there are several surgical approaches that are used worldwide to surgically correct Hypospadias.
The main aim of this surgical procedure is to form a straight penis with normal urethral opening. This may be performed in four steps:
Straighten the penile shaft
Create urinary channel
Position the urethral opening correctly
Circumcising/reconstructing the foreskin