Does your little boy have this condition? Let's talk about Hypospadias

When you change your newborn baby's diaper, have you noticed anything strange or different about his penis ? Maybe you felt that the urethra was not where it should be, but a little lower. It is very normal for a mother or father to feel very scared and worried when you see something like that. But don't worry. Today we are talking about this condition that many mothers and fathers ask about, that is commonly seen, and that is born in many male children, namely hypospadias.

Simply put, what is hypospadias?

Okay, let's explain this very simply. Hypospadias is a birth defect in which a boy's penis and foreskin do not develop properly. We have a tube in our body that carries urine and semen out, which we call the urethra . Normally, this urethra ends at the tip of the penis. Urine and semen come out through this opening. We call this the meatus.

Imagine that during the early stages of a baby's life in the womb, this urethra is formed as an open canal. As the baby grows, this canal closes and becomes a complete tube. However, in a baby with hypospadias, this tube called the urethra does not close completely. Therefore, the urethral opening (meatus) is located somewhere else, on the underside of the penis, instead of at the tip.

This hole can be located anywhere on the penis , in the scrotum, or even near the anus.

Is this a serious problem? Should I be afraid?

As a mother, this is probably the biggest question on your mind. In fact, this condition can range from mild to severe. If it is very mild, surgery may not be necessary. However, in most cases, surgery can completely correct this condition. So, first of all, remember that this is not a lifelong problem that cannot be solved. With proper treatment, the child can live a normal life without any problems in the future.

What types of hypospadias are there?

Doctors classify this condition based on where the urethra is located. It's important for you to know this too.

What are the symptoms of this condition?

The main symptom is that the urethral opening is not at the tip of the penis. Apart from that, there may be several other symptoms.

• Change in the way you urinate : Urine may not flow straight forward, but may flow downward or to the sides. Think of it like a squirt gun, with urine flowing in all directions. This can also cause infections of the surrounding skin .
• Underdeveloped foreskin:The foreskin may not completely cover the head of the penis, but may only be a hood on the top. Here is something very important. That is, if your child has this condition, do not circumcise him without consulting a doctor for any reason. Because doctors have to use this foreskin when performing the surgery.
• Chordee: Some children's penises may be bent downward like a hook instead of being straight.
• Undescended testicles : Sometimes, in boys with hypospadias, one or both testicles may not have descended into the scrotum.

What is the exact cause of hypospadias?

To be honest, doctors and researchers still haven't found a definitive cause for this, but they have identified several factors that increase the risk of this condition.

• A hereditary link: If a father, grandfather, or uncle in the family has had this condition, there is a chance that the baby will also have it.
• Maternal conditions during pregnancy :
• Mother's age over 35.
• The mother's body mass index (BMI) is more than 30 (obesity).
• Fertility treatment for pregnancy. There is some suspicion that the hormone ``Progesterone`` given, especially in the early stages of pregnancy, may have an effect.
• Use of other hormones during pregnancy.
• Environmental factors: Exposure of the mother to certain chemicals and pesticides during pregnancy.
• Smoking: Mother smoking during pregnancy.

How does a doctor recognize this?

This is usually very easy to recognize. It is easily seen by a pediatrician when examining the baby after birth. The doctor can identify it by looking at the location of the urethral opening on the penis and the shape of the foreskin.

At that point, the doctor will refer you to a pediatric urologist.

How is it treated? Let's learn about the surgery

The only successful treatment for hypospadias is surgery (hypospadias repair).

When is the surgery performed?

Most often, specialist doctors perform this surgery when the baby is between 6 and 12 months old. There are several reasons for performing the surgery at this age.

• It's easier to take care of the wound after surgery and keep it clean at this age.
• It is safest for a child at this age to be given general anesthesia.
• The child will have no memory of this.

What happens during surgery?

This is a surgery that usually takes a few hours. In most cases, the baby can be sent home the same day (outpatient procedure). During the surgery, the doctor will do several main things.

1. Straightening the penis: If the penis is bent downward (chordee), it is straightened first.

2. Reconstruction of the urethra: The incomplete urethra (tube) is reconstructed and extended to the tip of the penis.

3. Reshaping the foreskin: The remaining foreskin skin is used to give the penis a normal appearance. Circumcision is often performed at this time.

4. Temporary catheterization: Sometimes, after surgery, a small tube (Foley catheter) is placed to drain urine until the urethra heals. The doctor will remove the tube at your follow-up visit in a week or two.

What complications can occur after surgery?

As with any surgery, there are some risks, but these are very rare.

• Infection: There is a risk of infection in the wound.
• Bleeding: Minor bleeding may occur.
• Urethrocutaneous fistula: A small hole forms between the newly formed urethra and the skin of the penis. This can cause urine to leak out of the way.
• Urethral stricture: A narrowing of the urethra caused by a scar at the surgical site. This can cause difficulty urinating and narrowing of the urethra.
• Urethral diverticulum: A part of the urethra swells up like a balloon, and urine can collect inside it.
• Recurrent curvature: The penis may curve downward again after some time after surgery.

If something like this happens, it may need to be corrected with another minor surgery. But these are very rare things.

How to take care of the baby after surgery?

Your care is very important for the success of the surgery.

• Cleanliness: Follow your doctor's instructions exactly. Every time you change a diaper, wash your hands thoroughly with soap and water before touching your baby's area. If urine or feces get on your baby's skin, wash your hands with soap and warm water and pat dry with a clean cloth.
• Bathing: Do not bathe the baby in a tub of water until the catheter is removed. Sponge-bath. Be careful not to pull on the catheter.
• Activities: Don't let your baby crawl until he is two to three weeks old. Also, don't let him sit on toys that have legs on either side, such as bicycles, swings, and rocking horses.
• Swelling and discoloration:It is very normal for the penis to be swollen and blue-purple after surgery. Don't worry. It will gradually subside over a month or two.

When should I see a doctor or go to the ETU?

If an emergency occurs after surgery, it is important to act immediately.