Hypospadias with chordee question

   My son, Arlo was born with penoscrotal hypospadias with chordee.  
  He had surgery at the age of 10 months to correct this, and then
   again when he was 18 months to correct a fistula which had
  developed.  I'm wondering now if we did the right thing, or should
  have waited until he was older and could decide for himself what to
  do.  He has scar tissue, and I'm wondering if this will interfere
  with his sex life when he's older.  I also wonder what sort of
  other problems may develop as he gets older.  Ideally, I'd like to
  hear from other people who've had this same condition and surgury
  done.  Thank you, Kristen

[hfhs M.D.-AK]

Dear Kristen,
The appropriate age for the repair of hypospadias is largely determined by the size of the penis.  Some distinguished hypospadias surgeons believe the ideal window for this operation is between 6 and 18 months.  There however is a more recent trend to move the surgery up in order to minimize th emotional effects of this event.  Some pediatric urologists are advocating performing the surgery  between 3 and 9 months.  The former thought was to do the surgery between 2 and 5 years of age.  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.  These unfortunate outcomes occur even in the most skilled hypospadias surgeons hands.  It is often necessary to remove the problem, plagued urethra, created previously and start anew.
There are five basic elements for a successful hypospadias outcome: meatoplasty and glanuloplasty, orthoplasty(straightening), urethroplasty, skin coverage, and scrotoplasy.  Due to the complicated case of your son, in would not be inappropriate to perform his operation in stages, however a surgeon must due what he or she is comfortable with to achieve good results.
The most common complications are fistulas of the urethra and strictures.  These must be repaired as needed and at the discretion of your surgeon.  I don

[MOHANB]

A related discussion, Hypospodias with Chordee was started.