A Complete Guide to Hypospadias Surgery for Infants

Did you know that around 1 out of 200 male infants are born with hypospadias, a condition where the urethral opening is not located at the tip of the penis? Fortunately, hypospadias surgery in infants is a well-practised solution to help correct this condition, ensuring a healthier future for your baby. 

In this article, we will break down the process, including early signs, when the surgery is required and how the recovery works to ensure the best possible outcome for your little one. 

A] Understanding Hypospadias

Hypospadias is a congenital condition where the urethral opening is misplaced. This medical condition develops when the urethra is not entirely developed during fetal growth. While the exact reasons for hypospadias in babies are unclear, genetics and environmental factors play a role.

There are three primary types of hypospadias:

• Distal Hypospadias: This is a common type of hypospadias where the urethral opening is closer to the penis tip. 
• Mid-Shaft Hypospadias: Infants with mid-shaft hypospadias typically have their urethral opening in the centre of the shaft.
• Proximal Hypospadias: The urethral opening for this condition exists at the penis’ base area and is considered the most severe form. 

Assessing hypospadias in newborns remains essential because early diagnosis can help with immediate surgical intervention. If you notice any abnormalities in the positioning of the urethral opening or your baby’s penis curvature, it is important to consult a paediatric doctor. Dr. Bhushanrao Jadhav is a paediatric surgeon in Dubai who has helped various families navigate this diagnosis and provided excellent care for their babies. 

B] Importance of Surgery for Hypospadias

Although symptoms of hypospadias in babies can vary, it is often recommended to have surgery, especially in moderate to severe forms. If left untreated, it can create urinary complications and challenges that can lead to emotional distress about penile appearance. The goal of this procedure moves the opening of the urethra forward so the penis can function normally. 

Surgery provides several important benefits:

• Restores Urinary Function: Surgery delivers effective urinary correction, producing normal urine flow.
• Improves Aesthetic Appearance: The penis is reconstructed into a more standard shape, thus improving self-image substantially.
• Prevents Future Complications: Early surgical intervention decreases the chance of developing future problems, including sexual dysfunction issues as well as fertility complications during adulthood.
• Psychological Benefits: Early medical treatment of hypospadias prevents future psychological strain caused by visible penile differences which develop during childhood years.

C] When is Hypospadias Surgery Performed?

Hypospadias surgery in infants is performed between 6 to 18 months of age. Early intervention is important as infants tend to heal faster, and surgery performed early in life often results in better outcomes. 

Why is Early Surgery Important?

• Faster Healing: Babies’ tissues are still growing and developing, which makes them more adaptable to surgery.
• Reduced Risk of Complications: Early surgery execution leads to decreased risks of future complications regarding urination, sexual development and fertility.
• Better Development: As children grow, the surgical intervention maintains normal development of both the penis and urethra.

The timing for surgical operation depends mainly on hypospadias conditions, the patient’s medical condition, and their projected growth rate. Patients with severe hypospadias condition should have earlier correction procedures to avoid complications.

D] The Hypospadias Surgery Procedure

Pre-Procedure

A medical evaluation will happen before surgery to check for both surgery readiness and the overall health of the baby. A paediatric urologist evaluates the patient’s hypospadias condition and picks the most appropriate surgical method for treatment. Before the procedure, the baby will be put under general anaesthesia for painless surgery.

Procedure

Depending on the severity of the child’s case, the surgeon will perform the required procedure. Some of them are as follows:

• Tubularisation (Snodgrass Procedure): It is the primary treatment option for distal hypospadias in infants. It reconstructs a new urethra through penile shaft tissue folding and suturing.
• Tip-to-Shaft (Kastner or Mathieu Procedure): The surgeons create the urethral pore on the penile tip through the transfer of neighbouring tissue for patients with distal and mid-shaft hypospadias.
• Single Stage Repair: It is preferred for mild cases of hypospadias and involves a single procedure to correct urethral opening and penile curvature, as well as the use of skin grafts for reconstruction. 
• Two-Stage Repair: For extreme cases of hypospadias, it is spread across two separate operations. The first surgical stage focuses on correcting the curvature, while the second stage constructs the new urethra using a graft. 
• Meatal Advancement and Glanuloplasty (MAGPI): MAGPI surgery shifts the urethral hole to the penis tip while redoing the penile tissue structure to achieve both functionality and pleasing aesthetics.

E] Recovery and Aftercare

Recovery from hypospadias surgery typically takes a few weeks, and it’s essential to follow your doctor’s aftercare instructions to ensure proper healing.

What to Expect During Recovery:

• Swelling and Discomfort: Normal post-operation symptoms include moderate swelling and tenderness, which doctors manage with medicine for pain relief.
• Signs of Infection: Check for growing inflammation, swelling or discharge, as these symptoms can signal an infection.
• Gentle Care: When you change your child’s diapers, keep surgical site pressure to a minimum while following exact cleaning directions.

Post-Operative Care:

• Monitor the Surgical Site: Check often for new symptoms or abnormal signs coming from the surgical site.
• Follow-Up Appointments: Regular visits to your paediatric urologist to check that surgery site recovery proceeds well and to identify possible complications.

For more detailed guidance on how to identify hypospadias in babies, consult our paediatric surgeon in Dubai. Our doctor offers tailored advice based on the specific needs of the baby. 

Conclusion

Hypospadias surgery is important in ensuring the health and well-being of your baby boy. Early intervention helps achieve the best possible outcomes, so if you notice any signs or symptoms of hypospadias, do not wait to seek expert advice. A skilled paediatric urologist can help you guide through the treatment process, ensuring your child gets the best care possible. 

If you are looking for an experienced hypospadias surgeon in Dubai, do not hesitate to consult Dr. Bhushanrao Jadhav. With years of experience, we are dedicated to providing the best care for your child. Reach out to us to schedule a consultation and give your baby a healthier and happier future.

Dr. Bhushanrao Jadhav

Dr. Bhushanrao Jadhav is a highly skilled Pediatric Surgeon and Urologist specialising in minimally invasive and robotic surgeries for children. With advanced training from leading institutions in the UK, India and USA, he brings expertise in treating complex genitourinary conditions and neonatal surgical ailments. Driven by compassion and innovation, Dr. Jadhav has pioneered pediatric robotic surgery programs in Pune, India, ensuring world-class care tailored to children’s unique needs.