Hypospadias surgery procedure

The symptoms of hypospadias include abnormal position of the urethral opening and abnormal shape of the foreskin of the male urethral opening. Depending on the location of the urethral opening and the degree of penis curvature, doctors will adopt different surgical methods. The success of the surgery is related to the possibility of the patient's normal life. During the surgical treatment, the patient should maintain a good attitude, and the doctor should also pay attention to the patient's mental health and provide timely counseling and dredging. Let's learn about the specific process of the surgery.

How is hypospadias surgery performed?

The surgery is divided into two steps:

1. Correction of penile curvature;

2. Urethroplasty is often decided to be performed in stages or in one stage according to the specific situation of the child. Currently, the vast majority of children undergo a one-stage surgery, but if the deformity is severe, it must be performed in stages.

What is the success rate of hypospadias surgery?

There are many surgical methods for treating hypospadias. Doctors will adopt individualized treatment plans based on the individual differences of patients. However, the operation is very complicated and there is a certain possibility of surgical failure. The first-stage success rate of general surgery is 80%, and the success rate of severe hypospadias is slightly lower.

What is the effect after hypospadias surgery?

After surgery, most patients can achieve the following results:

(1) Correction of penile flexion;

(2) Repair or rebuild the missing urethra;

(3) The urethral opening is located at the tip of the glans penis;

(4) The penis is close to normal in appearance, can urinate while standing, and can have normal sexual intercourse in adulthood.

What to do if the incision hurts after hypospadias surgery?

The penis is prone to postoperative pain due to the dense distribution of sensory nerves. Analgesics can be used to treat the symptoms. Common methods include oral or intramuscular injection of analgesics, sedatives, and intravenous medication.

What unexpected complications may occur after hypospadias surgery? What should I pay attention to?

(1) Urethral fistula: It is the most common complication after surgery. It means that in addition to the urethral opening, the patient also has an abnormal opening in the penis or perineum. When the patient urinates, urine is discharged from the urethral opening as well as the fistula opening. The incidence rate reported varies, ranging from 20-40%. The main reasons are poor blood supply of urethroplasty materials, local tissue ischemia, necrosis, and infection. It can also be caused by poor urine drainage and urethral infection, which causes it to rupture. Urethral fistula should not be treated hastily. It should be repaired 3-6 months after the operation, when the local skin scar softens and the blood supply is reestablished;

(2) Urethral stenosis: It can occur at the glans urethra and urethral anastomosis. Poor blood supply to the newly formed urethra or urethral torsion and deformation are common causes. Urethral dilation can be performed. If it is ineffective, a fistula incision is required at the urethral stricture, and a fistula repair surgery is performed 6 months later.

(3) Urethral pseudodiverticulum: This is mostly caused by the inelasticity of the newly formed urethral material and the lack of supporting tissue around the urethra. It is often secondary to urethral stenosis, causing the urethral wall to protrude outward, and requires surgical removal of the urethral diverticulum.

(4) Skin flap necrosis or dehiscence: This mainly occurs at the distal end of the skin tube that forms the urethra, which has poor blood supply. Urination too quickly and too quickly in the early postoperative period will increase urethral pressure and cause penile wound dehiscence. At the same time, the surgical site is close to the anus and is prone to infection.