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S.J., 8 months old baby was brought to the clinic with abnormal looking penis and passage of urine form underside of penis almost near the scrotum. On examination, he had a condition called Penoscrotal Hypospadias with mild chordee (abnormality where the penis is bent downwards). The baby was planned for a corrective surgery called – SINGLE STAGE URETHROPLASTY which can be done by multiple techniques. The exact technique in this case was a long Transverse Island flap urethroplasty.
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This is the appropriate age (6-9 months) for such surgeries as the final results are very good both cosmetically and functionally at such a young age.
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The baby was taken up for surgery and he required only one day stay in the hospital. The dressing was removed on day5 and the catheter on day12.
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At 3 months follow-up he has a normal looking circumcised penis with a urethral opening at the tip of the glans.
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| severe hypospadias with the urinary opening near scrotum |
After degloving, penis made straight |
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Transverse Island Flap has been mobilized
based on dartos
tissue and reliable blood
supply from the dorsal prepuce. |
Completed urethroplasty with
Special Silicon catheter for diaper drainage |
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Important points about hypospadias:
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- Hypospadias is one of the most common anomalies worldwide.
- The correct age for corrective surgery is between 6-9 months.
- Most of the hypospadias can be corrected with a single stage surgery, rarely if the penis is too curved (chordee) or the skin is short or there is an associated disorder of sex differentiation, a two or a three stage surgery may be required.
- The success rate of Single Stage Urethroplasty in correctly chosen cases is more than 95%.
- Most common post-op problems (5%) are infection and formation of a fistula requiring a second surgery.
- www.hypospadiasfoundation.com
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