The physicians and staff of the Pediatric Urology Group evaluate and treat your child’s pediatric urological condition with the expertise of a skilled professional and the compassion of a caring parent.
Posterior Urethral Valves (PUV) Repair
Pyeloplasty, daVinci Robotic Assisted
Undescended Testis (Orchiopexy)
Urinary Tract Infection (UTI) Treatment
Vesicoureteral Reflux (VUR) Treatment
The loose fold of skin that covers the glans of the penis.
The external sac of skin enclosing the testes.
The canal through which urine is discharged from the bladder.
Hypospadias is a common birth defect that occurs in one out of every 150 to 300 boys. It is a condition in which the urethral opening does not form completely to the tip of the penis. Instead, the opening may be located anywhere along the underside of the penis. This results in a penis that may perform inefficiently and also appear visibly different.
In distal hypospadias, the urethral opening is found near the head of the penis. In proximal hypospadias, it is located anywhere from the middle of the penile shaft to the base of the penis or even behind the scrotum.
Usually hypospadias is apparent at birth, and is most commonly noticed by the appearance of the foreskin. In infants with hypospadias, the foreskin is typically incompletely developed, leaving the tip of the penis exposed. However, some male newborns may have abnormal foreskin covering a normally positioned urethral opening, while a complete foreskin may mask an abnormal urethral opening. In some cases, hypospadias is associated with a mild downward curvature of the penis.
Hypospadias repair is generally recommended before toilet training has taken place. However, some doctors prefer to wait until the child is 3 years old, especially if the repair will require extensive urethra reconstruction.
The hypospadias procedure is performed under general anesthesia. It is an outpatient procedure that usually takes 1-1/2 to 3 hours. In some cases, however, it may be done in stages if the surgeon wants to separately straighten the shaft before constructing the urinary channel.
The procedure itself will depend on the degree of hypospadias and the extent of the penile curvature. Mild hypospadias can be corrected in a one-step procedure. During this procedure, the opening of the urethra is moved forward and the penis head reshaped. If the hypospadias is more severe, the penis may be degloved (the skin separated from the shaft) in order to construct a new urethra that will reach to the tip of the penis. This may be done in one procedure or may require two or three procedures spaced out over several months.
After surgery, there will be swelling and bruising, which will improve over several weeks. A catheter may be in place for five days to two weeks, which the parent will be instructed on how to change and empty. Periodic follow-up visits will test for adequate urinary flow for the weeks and months after surgery. It is important for parents to adhere to a follow-up schedule to ensure the best possible outcome.