Mild Hypospadias and Incomplete Foreskin

[astrogal]

My son has mild hypospadias where he has an incomplete foreskin and the surgeon has said that his uretha opening is round not a slit like it should be. They want to circumcise him and make the opening more of a slit like shape. They said they cant repair the foreskin, do you know why this could be if she was able to shape the foreskin to show us what it should look like? I dont want to have the surgery done if it really is not necessary but if I left him the way he was would he have issues with his incomplete foreskin and opening? The foreskin pulls back quite far so we think that he may be prone to infections if he does not clean it properly but other than that will he have problems with intercourse with the foreskin catching and pulling or does a round opening mean he may not be able to ejaculate near a womens cervix and may have problems reproducing? His foreskin can make his penis look like its twisted around because of where the skins can sit. Have you seen what a boy with an incomplete foreskin as an adult looks like? Will it look normal while erect?

Thanks

[rmprdl1964]

Hi,

Penile hygiene for an uncircumcised penis is not very difficult and being the father of an 18 y/o old uncircumcised son can tell you that infections have not been part of his life.
I myself being uncircumcised as well and coming from a Europen background can tell you that a foreskin does not pose any hygiene problems.
I myself however do have problems with repeated infections due to a neurogenic bladder.
I have only had a female doctor suggest circumcision after swelling from a catheter having been in.

I would ask a different urologist for a second opinion. A few of the reasons that they might not be able to correct the foreskin is due to the possibility of creating scar tissue. The other reason would be that they have to create a wound like area of the two ends of the foreskin to get it to heal together. Just stitching it together will not end up with the foreskin growing together.

I had a younger brother who had to be circumcised at a later age (about 6) due to not being able to retract the foreskin. Even though this was done at the age of 6, it did not seem to have a major impact on him.

If the two ends of the foreskin cannot be brought together then circucision might be the better option. The goal is to end up with a penis that does not look abnormal, and one that does not interfere with the natural function of the penis.

All the best.

Ron

[astrogal]

Thanks for you replies. My son has a very mild degree of hypospadius. His urethera opening seems to be relatively in the right spot  just rounded instead of slit like (though i am not sure how much difference this makes as he wees just fine). He has the type of scarring on his penis that is common with hypospadius. My concern is moreso his foreskin. I am reluctant to get a circumcision (though my partner thinks we should get it done) because I am not sure if that is a decision I/we should be making for him. Because his foreskin does not connect at the bottom, it can pull back quite far, needs to be cleaned thoroughly and regularly underneath the foreskin, it can make his penis look twisted as it seems like it twists around the head resulting in it becoming quite red at times... We are both worried if he doesnt get cirumcised then he will be prone to infections, and the other reason for it is because then he will not have such an unusual looking penis. If he is circumcised he will look like the minority of boys who are cirumcised and he wont be the odd one out because we dont want him to grow up having issues that his penis looks different to all the other boys. The surgeon said that he does not have chordee so his foreskin is not needed for any reconstructive surgery, she just said it couldnt be repaired but i cant see any logical reason why because the skin is all there its just not connected at the bottom as far as i can see, it just needs to be stitched together (though i am not a dr so i am not sure if this is even possible, but logically i cant see why not as skin is stitched together all the time). The other issue is a time factor, if we are going to get him circumcised or repaired (if possible) we need to do it while he is young enough to not remember and he is already 7 months old.

[rmprdl1964]

Hi,

It is best not to have your son circumcised, the foreskin might be used in corrective surgery.
As for fear that he might have problems reproducing, I don't think that it will be a problem as long as he has good sperm. The reason that I think that he will have no problem conceiving taking in consideration that the testes produce healthy semen is out of my own experience after bladderneck surgery.

I have several problems that could have resulted in difficulties receiving. First I was born with undescended testicles. The left came down around the age of one or two, however the left did not descend untill I was about 12. Being uncircumcised and having a very tight frenulum, the glans is allmost at a 90 degree angle with the penis if the foreskin is completely retracted. This being the case one would think that semen would not enter cervix. My wife had two chidren when I needed prostate and bladder surgery. I was told that this surgery might result in difficulty conceiving as the surgery would lead to retrograde ejeculation. About 8 weeks after the surgery my wife and I wanted to check if semen was ejeculated at the moment of climax. There was no visable semen, but yet there was some sensation of ejeculation. A few hours later while going to the toilet to urinate I noticed that the semen came out of the bladder while urinating. Both my wife and I were under the conclusion that I was no longer firtile. To our surprise my wife became pregnant and our youngest daughter was born about twelve to thirteen months after my surgery. My urologist was somewhat surprised as well.
Your son not having a complete foreskin does not present any problems with conception. I agree with z726.
I hope that this will put your mind at ease. Should a urologist recomend surgery correct the hypospadia, then the foreskin may be used for this surgery.
There are also men who have had a dorsal slit of the foreskin and have not had a circumcision done, yet they were able to conceive.

All the best.

Ron

[z726]

It is possible to correct the condition without circumcision; in addition to moving the urethra opening, there is a procedure called foreskin reconstruction. Sounds like the surgeon at your hospital may not know about this.

It's also possible your son would do fine if left alone. There shouldn't be any difficulty with reproducing when he's older - not everyone ejaculates with much force, and the semen deposited in the vagina would be squeezed into the cervix anyway when the penis pulled out. A while ago the Wikipedia article had a picture of an adult's penis with a more pronounced (but less common) degree of hypospadias:
http://en.wikipedia.org/w/index.php?title=Hypospadias&oldid=305032822