Re: Hypospadias with chordee question

Posted By ED on August 18, 1998 at 17:29:24:

In Reply to: Re: Hypospadias with chordee question posted by HFHS M.D.-AK on August 12, 1998 at 10:43:40:






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



______
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 dont have the ability to see your child but if you are dissatisfied  with the result you may want to discuss this with your surgeon.
This information is provided for general medical educational purposes only.  Please consult your physician for diagnostic and treatment options pertaining to your specific medical condition.  More individualized care is available at the Henry Ford Hospital and its satellites (1 800 653-6568).
Sincerely,
HFHS M.D.-AK
*keyword:Hypospadias