Hypospadias is a congenital condition in boys in which the urethral opening (meatus) is not located at the tip of the penis. Instead, it is positioned along the underside of the penis, anywhere from just below the head to the junction of the penis and scrotum. This developmental abnormality occurs between 8 and 14 weeks of pregnancy, when the urethra and penile structures are forming.
Hypospadias affects approximately 1 in 300 male births and varies in severity depending on the location of the urethral opening.
Types of Hypospadias:
Hypospadias is classified based on the position of the abnormal opening:
- Subcoronal (Distal Type): Opening located near the head of the penis.
- Midshaft: Opening situated along the penile shaft.
- Penoscrotal (Proximal Type): Opening located near the scrotum; often associated with more complex anatomical changes.
The more proximal the opening, the more complex the condition.
Associated Features:
In addition to the misplaced urethral opening, children with hypospadias may have:
- A hooded foreskin (incomplete development on the underside).
- Chordee — a downward curvature of the penis caused by tight fibrous tissue.
Chordee becomes more noticeable during erection and may interfere with normal urinary function and, later in life, sexual function if not corrected.
Problems if Left Untreated:
If untreated, hypospadias can cause:
- Abnormal urinary stream or spraying.
- Difficulty directing urine forward while standing.
- Psychological concerns related to cosmetic appearance.
- Curvature affecting future sexual function in severe cases.
Early evaluation ensures appropriate planning and correction.
Treatment of Hypospadias:
Mild cases without curvature may not require intervention. However, most children benefit from surgical correction. Hypospadias Surgery in Delhi is typically performed between 6 and 18 months of age, allowing optimal healing and minimizing psychological impact.
The goals of surgery are:
- To position the urethral opening at the tip of the penis.
- To straighten the penis by correcting chordee.
- To achieve a cosmetically normal appearance.
In many cases, repair is completed in a single stage. Complex or proximal hypospadias may require a staged approach. The foreskin is often used to reconstruct the urethra; therefore, circumcision should not be performed before corrective surgery.
Postoperative Care:
After surgery, the child will have a dressing and a urinary catheter to allow healing. Hospital stay is usually brief (about two days). The catheter and dressing typically remain in place for 7–10 days.
Postoperative management includes:
- Pain relief medications (such as paracetamol).
- Anticholinergic medicines to reduce bladder spasms caused by the catheter.
- Antibiotics to prevent infection.
- Laxatives if required to avoid constipation.
Parents are advised to:
- Encourage adequate fluid intake.
- Ensure the catheter drains continuously.
- Avoid bathing until the catheter is removed (sponge cleaning is permitted).
- Use double diapers in younger children to prevent contamination.
- Avoid outdoor play, cycling, or straddle toys until healing is complete.
Possible Risks:
Although outcomes are generally excellent, potential complications include:
- Fistula formation (urine passing through an additional small opening).
- Narrowing of the new urethral opening (meatal stenosis).
- Infection or bleeding.
Most complications are manageable with timely medical care.
Choosing the Right Specialist:
Successful correction depends heavily on surgical expertise and meticulous postoperative care. Dr. Prashant Jain is widely recognized as the Best Pediatric Surgeon in Delhi, with extensive experience in managing simple and complex hypospadias cases. His patient-centered approach, advanced surgical techniques, and structured follow-up ensure optimal functional and cosmetic outcomes.
With early diagnosis and expert intervention, children undergoing Hypospadias Surgery in Delhi can achieve normal urinary function and healthy development.
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