Hypospadia elective surgery - risks and choices

[Bean098]

Our 13 month old has mild (stage 1) hypospadia and also adhesion after circumcision. Since the hypospadia is mild, it seems the surgery is elective. What are all of the issues we should take into account when making this decision. What is the incidence of infection, future erectile dysfunction, scarring, etc.? What issues and complications or benefits could there be both with surgery and if we do not have the surgery? We need help understanding both options thoroughly. To date, there has been no infection or visible problem other than the low opening (about 1/8 inch low).

With the adhesion, we were also told it could be pulled back manually or handled in surgery while treating the hypospadia. Is there a better rate of success one way or the other and again what are the complications we should consider cosmetically and functionally, (emotionally)?

Thank you for your response.

[Kevin Pho, MD]

The following lists the complications that can occur from hypospadia repair.  I cannot quote exact rates, since they would vary based on the surgical experience of the urologist, as well as the indivdual complexity of the procedure being considered:

* Wound dehiscence. Dehiscence means that the incision splits apart or reopens. It is treated by a follow-up operation.

* Bladder spasms. These are a reaction to the presence of a urinary catheter, and are treated by giving medications to relax the bladder muscles.

* Fistula formation. A fistula is an abnormal opening that forms between the reconstructed urethra and the skin. Most fistulae that form after hypospadias surgery close by themselves within a few months. The remainder can be closed surgically.

* Recurrent chordee. This complication requires another operation to remove excess fibrous tissue.

* Urethral stenosis. Narrowing of the urethral opening after surgery is treated by dilating the meatus with urethral probes.

These are in addition to the risks of bleeding and infection common to all surgeries.

These potential complications should be discussed with your personal urologist.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
kevinmd_b

[joseph1000]

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[Lee352]

A related discussion, Hypospadia Surgery was started.