Hypospadias a condition in which the opening of the urethra is on the underside of the penis, rather than in its normal location at the tip of the penis. About half the time the opening is within an inch of the penis tip. This is known as anterior hypospadias.
Who is a candidate for the procedure?
Anyone with this condition is a candidate for surgery, since the problem cannot be treated any other way. When the urethral opening is located at the base of the head of the penis, it does not interfere with the normal functions of the penis. However, the problem is often corrected to avoid psychological problems that can come from an abnormal appearance of the penis. The procedure is usually done on children between the ages of 6 and 18 months. Surgery on infants under 6 months carries a higher risk from anesthesia.
How is the procedure performed?
The surgery is usually performed under general anesthesia, which means that the child is put to sleep with medications, feels no pain, and has no awareness of the procedure.
There are many techniques for hypospadias repair. Newer methods accomplish the repair in one stage. The repair procedure is relatively simple when the opening is near the head of the penis.
The operation is more complex when the urethral opening is along the penile shaft or scrotum. In these cases, tissue flaps or skin grafts may need to be transplanted from other sites. Associated curve or incomplete foreskin are surgically corrected at that time. A urinary catheter, or a narrow tube called a stent, is put in place for a short period of time to keep the urethra opened.
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Tierney, Lawrence, editor, "Current Medical Diagnosis and Treatment, 39th edition", 2000