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Urology (Expert Forum)
Hyposadius
Questions in the Urology forum are answered by Dr. Stephen Liroff, affiliated with the Henry Ford Hospital. Topics covered include benign prostate disease, penis curvature, cystisis, kidney stones, pediatric urology, prostate, sexual dysfunction, urinary tract infections (UTI), and urological cancers.
Hyposadius
by Smells, Oct 06, 1999 12:00AM
My 6 week old son has a third degree hypospadius, while he uninates fine he has never had a erection. Is this common? Is it something that can be corrected? We already have an appointment with a specialists and I'm hoping to ask the right questions to understand what we should be most concerned about and is there anything we can do to help with the problem.
Doctor's Answer
by HFHS M.D.-BE, Oct 12, 1999 12:00AM
Dear Smells,
A third degree hypospadias is when the opening of the urethra which is normally at the tip of the penis, develops abnormally and is located at the region between the perineum (the crotch) and the junction of the scrotum and penile shaft. This kind of hypospadias is the most challenging to repair. It often is repaired in more than one stage. Further it has a higher complication rate than the less severe forms.
The appropriate age for the repair of hypospadias is largely determined by the size of the penis and the concern for the emotional trauma of the surgery and possible complications. Some well known hypospadias surgeons believe the ideal window for this operation is between 6 and 18 months. Never has the ideal age of correction been later in life to where the child could make their own decision.
There are patients who have had multiple hypospadias repairs to achieve a good cosmetic and functional result, just as your son might. Poor outcomes occur even in the most skilled hypospadias surgeon’s hands.
The most common complications are fistulas of the urethra (side holes in the reconstructed portion of the urethra) and strictures (narrowings in the reconstructed urethra). These will require further surgery to repair.
Erectile dysfunction is not a part of the hypospadius complex of problems. My guess is that you have just not been present at the “right time.” Primary impotence is an extremely uncommon problem that, if present, will need to be treated well into puberty.
Sincerely, This information is provided for general medical information purposes only. Please consult your physician for diagnostic and treatment options pertaining to your specific medical condition. Dr.S. Liroff at our institution has interest in pediatric urology and I would be glad to see him for this problem. If you would like to make an appointment [for a second opinion], please call us at 1-800-653-6568. We can also arrange local accommodations through this number if this is your need. Please bring any x-rays [and pathology slides] (not just the reports) as well as any physicians’
notes and lab test results that you may be able to obtain. These will help us greatly.
HFHS M.D.-BE
A third degree hypospadias is when the opening of the urethra which is normally at the tip of the penis, develops abnormally and is located at the region between the perineum (the crotch) and the junction of the scrotum and penile shaft. This kind of hypospadias is the most challenging to repair. It often is repaired in more than one stage. Further it has a higher complication rate than the less severe forms.
The appropriate age for the repair of hypospadias is largely determined by the size of the penis and the concern for the emotional trauma of the surgery and possible complications. Some well known hypospadias surgeons believe the ideal window for this operation is between 6 and 18 months. Never has the ideal age of correction been later in life to where the child could make their own decision.
There are patients who have had multiple hypospadias repairs to achieve a good cosmetic and functional result, just as your son might. Poor outcomes occur even in the most skilled hypospadias surgeon’s hands.
The most common complications are fistulas of the urethra (side holes in the reconstructed portion of the urethra) and strictures (narrowings in the reconstructed urethra). These will require further surgery to repair.
Erectile dysfunction is not a part of the hypospadius complex of problems. My guess is that you have just not been present at the “right time.” Primary impotence is an extremely uncommon problem that, if present, will need to be treated well into puberty.
Sincerely, This information is provided for general medical information purposes only. Please consult your physician for diagnostic and treatment options pertaining to your specific medical condition. Dr.S. Liroff at our institution has interest in pediatric urology and I would be glad to see him for this problem. If you would like to make an appointment [for a second opinion], please call us at 1-800-653-6568. We can also arrange local accommodations through this number if this is your need. Please bring any x-rays [and pathology slides] (not just the reports) as well as any physicians’
notes and lab test results that you may be able to obtain. These will help us greatly.
HFHS M.D.-BE
