Hypospadias

Forms of hypospadias

Hypospadias can be glandular, coronal, scrotal, stem and perineal – its shape depends on the location of the opening of the urethra. Each form implies an individual approach to treatment: some do not require treatment, others must be treated. Let's consider what needs to be done depending on which form of hypospadias is determined.

In cephalic hypospadias, the external opening of the urethra is slightly displaced from the tip of the penis down into the region of the coronal sulcus. There is no curvature of the penis in this form, urination is not impaired, and there will be no problems in an adult man's sexual life – cephalic hypospadias are more likely to be a cosmetic defect.

Coronal, also known as coronary hypospadias, is the location of the opening of the urethra in the area of the coronal groove of the penis. In this form, there is an obvious defect in the appearance of the penis, up to the lowering of the head, and possible functional abnormalities. Coronary hypospadias usually require surgical intervention. The operation includes the alignment of the head of the penis, the displacement of the opening of the urethra to the tip of the glans penis and the plasty of the foreskin.

With stem hypospadias, the external opening of the urethra is located on the trunk of the penis, which makes it impossible or extremely difficult to urinate while standing, and also complicates a man's sex life – there is a curvature of the penis during an erection. Surgical treatment in this case is already absolute. During the operation, the penis is straightened and the opening of the urethra is moved closer to the head.

And the last forms of hypospadias, scrotal and perineal, are the most serious congenital pathologies that can even cast doubt on the child's gender identity. In such cases, the operation is absolutely indicated, since, starting from childhood, the boy will not be able to urinate while standing, and his sexual activity in adulthood will be impossible due to severe penis deformity.

Examination and preparation for surgery

A visual examination will allow not only to diagnose hypospadias, but also to determine its shape, the condition of the urethra and the degree of deformation of the penis. All these characteristics are necessary to solve the main issue – the type of hypospadias and the method of reconstructive surgery. In complex forms of this disease, genetic, ultrasound and other studies may also be required.

If indicated for surgery, blood and urine tests should be performed, and other specialists, including an anesthesiologist, should be consulted. The operation is performed under general anesthesia and lasts from one to several hours, depending on the degree of correction.

Operations for hypospadias in EMC

Currently, there are about 200 types of operations to correct hypospadias, but none of these types can be called universal, each case requires an individual approach. It is very important to note that the success and safety of hypospadias treatment depends entirely on the technical and theoretical training of the surgeon; the urologist must know and improve the methods of modern surgical interventions, master the elements of microsurgery and skills of working under optical magnification.

Another factor influencing the success of surgical treatment of hypospadias is the modern equipment of the operating room, the use of special tools, including consumables and sutures. Anaesthetic support is also important – it allows for long-term operations in children of the first years of life.

Surgical treatment of hypospadias in all forms sets such important goals as:

• reconstruction of the missing urethral segment

• penile straightening;

• moving the opening of the urethra to its normal location — the tip of the glans penis.

• achieving aesthetic appearance and full functions of the penis

The doctors of the EMC clinic perform both primary and repeated operations for hypospadias, striving to completely eliminate this problem and completely restore the functions and appearance of the penis.