Hypospadias Surgery – Risk Factors, Difficulties & Treatment

Hypospadias Surgery – Risk Factors, Difficulties And Treatment

For men, hypospadias is the embarrassing condition of having an out-of-place urinary opening. The urinary opening may be situated along the shaft of the penis, at the base of the scrotum or at one side of the penis head instead of the tip of the penis, its normal place. The condition is indeed embarrassing, but if you are suffering from this condition, you can take heart from the fact that even Adolf Hitler suffered from this abnormality. Indeed, it is said that Adolf Hitler did suffer from undescended testicles as well as hypospadias.

The Fuehrer might have been too distracted to go under the scalpel or surgical correction might not have been present during those times, but you don’t have these limitations. You have the opportunity to go under the scalpel and rectify the problem. You need to choose the right path to get rid of the problem and not get distracted like Adolf Hitler. Indeed, surgical correction is the right path. However, it depends on the condition of your hypospadias. In many cases, the condition does not create much of a problem while in a number of cases it creates a number of problems. If you want to put up with slight discomforts you don’t need surgery. However, if it has really been bothering you and affecting your daily life, you do need to rectify the condition and that involves surgery.

What is Hypospadias?

It is a congenital malformation of the penis which usually presents in three ways:-

  1. The urinary hole, also known as the meatus, is not situated in its normal place, i.e tip of the penis. It is present along the shaft of the penis, at one side of the penile head, or at the base of the shaft, i.e near the scrotum. However, this does not change the pattern of urination.
  2. The penis itself may be underdeveloped leading to the foreskin gathering at the back of the penis. This gives the appearance of a hood and may even look like a circumcised penis.
  3. There is no problem with erection, but even when the penis is fully erect, it is still bent or curved. This has the effect of hindering sexual activities including penetration. Such a bend is normally observed downwards.

Number Of People Suffering From Hypospadias

Considering the reported cases, it can be safely inferred that about one person in every 300 may suffer from some form of hypospadias. However, there are many unreported cases too. This can take the number of occurrences to about 1 in 125-150 boys. This shows that hypospadias is more common than is thought to be.

How Does Hypospadias Affect Day To Day Life?

Going by instances, hypospadias can affect one’s regular activities in a number of ways.

  • Urination may be difficult depending on the location of the opening of the urinary tract. Men suffering from a highly displaced urinary opening may need to sit down for urination. So the location of the urinary opening may limit the usage of the toilet. Some of these sufferers may not at all be able to use urinals.
  • Sexual activity may be limited and uncomfortable. The penis may develop a bend and along with the underdeveloped foreskin, it may rob you of all the pleasure of sex. In fact, penetration may be painful for both of you.
  • Also, during ejaculation semen doesn’t come out from the urinary opening. Moreover, if the curvature is too much and the penis is shorter-than-normal, one may suffer from mechanical problem during penetration. So, men with severe hypospadias may also have difficulties with sex.

Despite all these problems, people often conceal the condition fearing embarrassment.

Risk Factors of Hypospadias Surgery

It is a congenital condition, so it is not possible to know what causes this condition. However, there are some risk factors that abate the development of hypospadias in newly born male children.

  • Family history

The condition is common in male babies having a family history of this abnormality.

  • Genetics

Hormonal imbalance aided by gene variation may give rise to such malformation of the genitals.

  • Maternal age

It has been observed that if the age of the mother is above 35, the risk of hypospadias increases in male babies born to the woman.

  • Exposure to substances during pregnancy

Some researchers suggest that exposure of the mother to certain compounds like pesticides, certain hormones or industrial chemicals may give rise to such a congenital abnormality in male babies born to them.

  • Obesity

Obesity in the mother may also contribute to its male child being born with hypospadias.

Preventive Steps Of Hypospadias Surgery

Prevention revolves around mothers. If you are a smoker, you need to quit smoking to reduce the risk of such malformations. Folic acid supplements during pregnancy and maintaining a healthy lifestyle and weight also helps with prevention.

Hypospadias Surgery

Treatment of Hypospadias Surgery

In extreme cases of urinary and/or sexual inconvenience, treatment is a necessity to rectify the position of the opening of the urinary tract. However, treatment means surgical rectification and this needs to be done in early childhood. Surgical correction is done only by a pediatric urologist.

The basic aim of the surgery is to bring back the penis to its normal anatomical condition, making it straight as well as moving the hole from its congenital position to the tip of the penis. Such surgery is done in different ways, but it basically involves reconfiguring the penile and urethral tissues with the help of incisions, stitches, and occasional grafts.

Doctors can rectify Hypospadias usually by a single surgery done as an outpatient. However, some severe forms of the abnormality may require more than one surgery.

The hypospadias surgery may be time taking if it involves a tissue graft. Such a graft require if the urinary opening is near the scrotum or the base of the penis. In this case, the surgeon needs to harvest tissue grafts from the penile foreskin or inside of the mouth to reconstruct the channel and make it come out through most the proper position, the top of the penis.

Result Of Hypospadias Surgery

Surgery is usually successful and the penis looks absolutely normal after a successful surgery. Not only so, but boys also experience normal urination as well as reproduction. However, sometimes surgery may follow by the development of a fistula along the underbelly of the penis in the place where the newly reconstructed urinary drain is created. This may give rise to leakage of urine. Rarely, however, there may also be a problem with wound healing and even scarring. If there are any complications, the child may require another round of surgical hypospadias repair.

Follow-Up Care of Hypospadias Surgery

Follow up care is very important for your child. A couple of visits after the surgery can make things normal and heal the wound. However, you need to follow-up with the child’s urologist regularly for toilet training. At puberty too you need to follow up with a urologist to make sure there are no complications of the hypospadias surgery.

Conclusion For Hypospadias Surgery

Hypospadias Surgery is a highly treatable congenital anomaly if diagnosed in early stages. In some cases, hypospadias lies in disguise and that makes diagnosis difficult. You need to take the child to a urologist if you notice any abnormality in its urination pattern. A pediatric urologist is a competent person to diagnose hypospadias and also rectify it through surgical intervention.



Dr Gautam Banga

MBBS,MS,M.Ch (Urology)
Urologist, Andrologist and Genito -Urinary Reconstructive Surgeon
Contact no. : +91-9999062316
Email:- info@urethraandpenilesurgery.com

Medication and Surgery Options for Peyronie’s Disease Treatment

Peyronie’s disease refers to the disorder, where scar tissues i.e. plaque formed inside the penis of a man i.e. the organ used for sex and urination. The buildup of plaque takes place within the tissues of an elastic and thick membrane referred as tunica albuginea. Bottom or top of one’s penis is the common area associated with the buildup of plaque and it results in bending or curving of the penis and in turn, causes painful erections.

When Treatment Becomes Essential

Curves and bends make sexual intercourse difficult, painful or in some cases impossible. Moreover, Peyronie’s disease starts with swelling or inflammation, which later on, results in hard scars. In this situation, you have to consult with an expert andrologist and reconstructive urologist to get proper treatment based on your present condition.

Treatment Options Available to Cure the Problem

Observation Only Method

Your consulted andrologist and reconstructive urologist will recommend for the observation only method if-
• Penis curvature is not severe
• You have erections with mild or without any pain
• You have proper erectile function


Experts associated with peyronie’s disease treatment – infertility treatment recommend you various oral medications to treat your infertility condition. However, the most common medicine to cure the peyronie’s disease is Pentoxifylline, an oral medicine, which you have to take many months to reduce the formed scar tissues across the penile area. In some cases, doctors may inject the drug directly into the patient’s penis to reduce pain and curvature related to the disease.

Surgery Treatment

Doctors involved in peyronie’s disease treatment – infertility treatment recommend for surgery when your penis deformity reaches to the severe level. However, surgery type depends on individual condition, as the doctor considers the location of the plaque buildup, severity of one’s symptoms and related factors.

Suturing or Plication of Unaffected Penis Side

Surgeons opt for different procedures to plicate or suture the long side of one’s penis i.e. the side, which does not possess scar tissues. In this way, surgery makes the penis straight even though the procedure remains confined to relatively less curvature and leads to penile shortening largely.

Excision/Incision and Grafting Method

With the combination of excision/incision and grafting surgery, andrologist and reconstructive urologist create cuts in the penis’ scar tissue to allow the sheath in stretching out and straightening of your penis. Even your surgeon may remove a few of the scar tissues. Later one, doctors sew a graft i.e. a piece of tissue taken from any other part of your body to cover holes present in tunica albuginea.

Penile Implantation

Third and the last surgical method related to peyronie’s disease treatment – infertility treatment is penile implantation, where doctors insert penile implants surgically to replace spongy and scar tissues filling with blood while your erection. Implants are of semi-rigid i.e. able to bent down and up manually to involve in sexual intercourse. Alternatively, your doctor may inflate the penile implant by using a pump in your scrotum.

Dr. Gautam Banga