Notes

Hypospadias

Birth defect in males where the urethra is not located on top of the glans penis.Encyclopedia Entry for Hypospadias :Hypospadias repair - discharge. Your child may feel sleepy when first at home. He may not feel like eating or drinking. He may also feel sick to his stomach or throw up the same day he had surgery. Your child's penis will be swollen and bruised. This will get better after a few weeks. Full healing will take up to 6 months. Your child may need a urinary catheter for 5 to 14 days after the surgery. The catheter may be held in place with small stitches. The health care provider will remove the stitches when your child does not need the catheter anymore. The catheter will drain into your child's diaper or a bag taped to his leg. Some urine may leak around the catheter when he urinates. There may also be a spot or two of blood. This is normal. If your child has a catheter, he may have bladder spasms. These may hurt, but they are not harmful. If a catheter has not been put in, urinating be uncomfortable the first day or 2 after surgery. Your child's provider may write a prescription for some medicines: Antibiotics to prevent infection. Medicines to relax the bladder and stop bladder spasms. These may cause your child's mouth to feel dry. Prescription pain medicine, if needed. You can also give your child acetaminophen (Tylenol) for pain.Your child may eat a normal diet. Make sure he drinks plenty of fluids. Fluids help keep the urine clean. A dressing with a clear plastic covering will be wrapped around the penis. If stool gets on the outside of the dressing, clean it gently with soapy water. Be sure to wipe away from the penis. DO NOT scrub. Give your child sponge baths until the dressing is off. When you do start bathing your son, use only warm water. DO NOT scrub. Gently pat him dry afterwards. Some oozing from the penis is normal. You may see some spotting on the dressings, diaper, or underpants. If your child is still in diapers, ask your provider about how to use two diapers instead of one. DO NOT use powders or ointments anywhere in the area before asking your child's provider if it is ok. Your child's provider will probably ask you to take off the dressing after 2 or 3 days and leave it off. You may do this during a bath. Be very careful not to pull on the urine catheter. You will need to change the dressing before this if: The dressing rolls down and is tight around the penis. No urine has passed through the catheter for 4 hours. Stool gets underneath the dressing (not just on top of it). Infants may do most of their normal activities except for swimming or playing in a sandbox. It is fine to take your baby for walks in the stroller. Older boys should avoid contact sports, riding bicycles, straddling any toys, or wrestling for 3 weeks. It is a good idea to keep your child home from preschool or daycare the first week after his surgery.Call the health care provider if your child has: Persistent low-grade fever or fever over 101 F (38.3 C) in the week after surgery. Increased swelling, pain, drainage, or bleeding from the wound. Trouble urinating. A lot of urine leakage around the catheter. This means the tube is blocked. Also call if: Your child has thrown up more than 3 times and cannot keep fluid down. The stitches holding the catheter come out. The diaper is dry when it is time to change it. You have any concerns about your child's condition.Snodgrass WT, Bush NC. Hypospadias.Encyclopedia Entry for Hypospadias :Hypospadias repair. Hypospadias repair is done most often when boys are between 6 months and 2 years old. The surgery is done as an outpatient. The child rarely has to spend a night in the hospital. Boys who are born with hypospadias should not be circumcised at birth. The extra tissue of the foreskin may be needed to repair the hypospadias during surgery. Before surgery, your child will receive general anesthesia. This will make him sleep and make him unable to feel pain during surgery. Mild defects may be repaired in one procedure. Severe defects may need two or more procedures. The surgeon will use a small piece of foreskin or tissue from another site to create a tube that increases the length of the urethra. Extending the length of the urethra will allow it to open at the tip of the penis. During surgery, the surgeon may place a catheter (tube) in the urethra to make it hold its new shape. The catheter may be sewn or fastened to the head of the penis to keep it in place. It will be removed 1 to 2 weeks after surgery. Most of the stitches used during surgery will dissolve on their own and will not have to be removed later.Hypospadias is one of the most common birth defects in boys. This surgery is performed on most boys who are born with the problem. If the repair is not done, problems may occur later on such as: Difficulty controlling and directing urine stream A curve in the penis during erection Decreased fertility Embarrassment about appearance of penis Surgery is not needed if the condition does not affect normal urination while standing, sexual function, or the deposit of semen.Risks for this procedure include: A hole that leaks urine (fistula) Large blood clot (hematoma) Scarring or narrowing of the repaired urethra.The child's health care provider may ask for a complete medical history and do a physical exam before the procedure. Always tell the provider: What medicines your child is taking Drugs, herbs, and vitamins your child is taking that you bought without a prescription Any allergies your child has to medicine, latex, tape, or skin cleaner Ask the child's provider which drugs your child should still take on the day of surgery. On the day of the surgery: Your child will most often be asked not to drink or eat anything after midnight the night before surgery. Give your child any drugs your provider told you to give your child with a small sip of water. You will be told when to arrive for the surgery. The provider will make sure your child is healthy enough for surgery. If your child is ill, the surgery may be delayed.Right after surgery, the child's penis will be taped to his belly so that it does not move. Often, a bulky dressing or plastic cup is placed over the penis to protect the surgical area. A urinary catheter (a tube used to drain urine from the bladder) will be put through the dressing so urine can flow into the diaper. Your child will be encouraged to drink fluids so that he will urinate. Urinating will keep pressure from building up in the urethra. Your child may be given medicine to relieve pain. Most of the time, the child can leave the hospital the same day as the surgery. If you live a long way from the hospital, you may want to stay in a hotel near the hospital for the first night after the surgery. Your provider will explain how to take care of your child at home after leaving the hospital.This surgery lasts a lifetime. Most children do well after this surgery. The penis will look almost or completely normal and function well. If your child has a complicated hypospadias, he may need more operations to improve the penis appearance or to repair a hole or narrowing in the urethra. Follow-up visits with a urologist may be needed after the surgery has healed. Boys will sometimes need to visit the urologist when they reach puberty.Urethroplasty; Meatoplasty; Glanuloplasty.Hypospadias repair - discharge Kegel exercises - self-care Surgical wound care - open.Hypospadius Hypospadias Hypospadias repair - series Hypospadias repair - series.Elder JS. Anomalies of the penis and urethra.Encyclopedia Entry for Hypospadias :Hypospadias. Hypospadias occurs in up to 4 in 1,000 newborn boys. The cause is often unknown. Sometimes, the condition is passed down through families.Symptoms depend on how severe the problem is. Most often, boys with this condition have the opening of the urethra near the tip of the penis on the underside. More severe forms of hypospadias occur when the opening is in the middle or base of the penis. Rarely, the opening is located in or behind the scrotum. This condition may cause a downward curve of the penis during an erection. Erections are common in infant boys. Other symptoms include: Abnormal spraying of urine Having to sit down to urinate Foreskin that makes the penis looks like it has a 'hood'.This problem is almost always diagnosed soon after birth during a physical exam. Imaging tests may be done to look for other congenital defects.Infants with hypospadias should not be circumcised. The foreskin should be kept intact for use in later surgical repair. In most cases, surgery is done before the child starts school. Today, most urologists recommend repair before the child is 18 months old. Surgery can be done as young as 4 months old. During the surgery, the penis is straightened and the opening is corrected using tissue grafts from the foreskin. The repair may require several surgeries.Results after surgery are most often good. In some cases, more surgery is needed to correct fistulas , narrowing of the urethra, or a return of the abnormal penis curve. Most males can have normal adult sexual activity.Call your health care provider if your son has: A curved penis during an erection Opening to the urethra that is not on the tip of the penis Incomplete (hooded) foreskin.Hypospadias repair - discharge.Elder JS. Anomalies of the penis and urethra.