Inborn Genital Anomalies
Hipospadias is a structural abnormality in which the urine hole is not on the edge of the penis but at a point on the frontier side of the penis. It is seen once in every 300 men. The more far the hole is from the edge, the worse gets the problem but the smaller gets the probability. The mostly seen one is the one close to the edge (glandular) and the least seen one is the perineal type.
With patients that have hipospadias, they usually have a band that lies between the hole and the edge of penis which is called the “chordee”. This band causes forward bending of the penis during erection. This is fixed during operation.
All the patients must be investigated for other organ abnormalities systematically and need intravenous pyelogram. Undescended testicles, kidney abnormalities, hernia and other inborn abnormalities might be diagnosed.
The structure of the penis of a patient with hipospadias is also different. Urethra and corpus spongiosum have not been formed. The band called the chordee deforms the shape by bending forward. It usually has the shape of spatula and it is flat. The circumcision skin on the front is usually missing.
The penis should reach to a sufficient size for surgery. However, the surgeon must be experienced. Otherwise a mistake can not be fixed easily. It is recommended not to have kids circumcised that have hipospadias. The circumcision skin will be used during surgery to form the new urine channel or to close the front of the penis. It is usually recommended to have it before the children attend school. There are many techniques, it depends on the choice of the surgeon.