A boy with severe hypospadias

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 with chordee correction which can be done by multiple techniques. The exact technique in this case was a long Transverse Island flap urethroplasty.

This is the appropriate age (6-9 months) for such surgeries as the final results of penoscrotal hypospadias repair urethroplasty are very good both cosmetically and functionally at such a young age.

The baby was taken up for hypospadias repair surgery and he required only one day stay in the hospital. The dressing was removed on day5 after urethroplasty for penoscrotal hypospadias and the catheter on day12.

At 3 months follow-up he has a normal looking circumcised penis with a urethral opening at the tip of the glans. These are the best results for urethroplasty repair for penoscrotal hypospadias.

severe hypospadias with the urinary opening near scrotum

After degloving, penis made straight

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

Important points about Penoscrotal hypospadias:

• Penoscrotal hypospadias is a severe type of hypospadias
• The best & right age for corrective surgery for penoscrotal hypospadias is between 6-15 months.
• Some of the penoscrotal 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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Watch videos of Onlay flap urethroplasty - Hypospadias Surgery by Dr A.K.Singal

Proximal Penile Hypospadias surgery vide by Dr A.K.Singal

Scrotal Hypospadias Surgery Video by Dr A.K.Singal