Does anybody have any opinions on the current state of hypospadias repair in children/adolescents? From what I've seen in my limited reading (I haven't done any urology rotations), it seems like, in some cases, the surgeries done to correct hypospadias cause more problems than they fix. I talked to a patient today who had SIXTEEN surgeries before he was 20 years old. He said that it caused a major amount of suffering throughout his childhood, and he feels that he would have been better off without any surgical intervention at all. In some milder cases of hypospadias, is it better just to have no surgery?
I'm just a medical student. however I had a clerkship with a pediatric urologist, and stayed at a holiday inn express. From what I saw there were large differences in the severity of hypospadias. The variation I saw was basically how far distal the opening was. I did not see or hear of any complications in repairs, and the urologist never made a big deal about it.
On my rotation, I saw various hypo repairs, and each of them were either mid shaft, or at least proximal to the glans. This procedure is done at a time interval (between 6 months to a year) usually, such that the child will not remember the surgery or the pain of recovery. The parents must make the decision that they believe is the best interest of the baby. One cannot presume to know whether a child would grow up to be grateful for or to resent the appearance of his penis with this surgery. Most of these operations are extremely successful and give the boy a normal appearing penis that will not give him troubles in gym class later in life. I feel bad for the young man who had to have that many surgeries, however, I think you can find just as many and more patients who are extremely grateful for the repair.
thanks for the replies. On another note, anybody have any theories about why the incidence of hypospadias is increasing? Some say that pollutants or discarded birth control pills in the water supply may have something to do with it.
