Is your little boy's urethra in a different place? Let's talk about Hypospadias!

When you change your newborn baby's diaper, have you noticed any changes in his genitals? You may have noticed that the urethral opening is not at the point where it should normally be, but rather a little lower. As a parent, this can be scary. But don't worry. This is a common condition that we know in medicine and can be present in many male babies at birth. Today we are talking about this condition called `(Hypospadias)`.

Simply put, what is Hypospadias?

Okay, let's explain this very simply. In a male, urine and sperm come out of his body through a tube that runs through his penis. We call this tube the urethra . Usually, this urethra ends in a small hole at the tip of the penis. We call this the meatus.

Early in the development of a baby in the womb, this urethra forms like an open canal. Later, the two sides of this canal join together to form a complete tube. Think of it like putting on a zipper.

In a child with `Hypospadias`, the urethra is not completely closed and does not end like a tube. It is as if the zipper is not put all the way up. Therefore, the opening through which urine comes out `(Meatus)` does not form at the tip of the penis, but a little below it, anywhere on the penis. Sometimes this hole can be located near the testicles `(Scrotum)`, or even near the anus `(Anus)`.

Is this situation serious? Is it something to be afraid of?

Hypospadias can range from mild to severe. In some very mild cases, surgery may not be necessary. However, in most cases, surgery can completely correct the condition. So, there is no need to worry about it. With proper treatment, the child can live a normal life without any problems in the future.

What are the types of Hypospadias?

Doctors divide this condition into several main types, depending on where the urethra is located. Let's take a look at what they are.

What are the symptoms of this condition?

The main symptom is the misalignment of the urethra. In addition, several other symptoms may be seen.

• Urination changes: When a child urinates, the stream of urine may not go straight forward, but may dribble downward or to the side . This can make it difficult for the child to urinate while standing as they get older.
• Incomplete foreskin: The skin covering the head of the penis (the foreskin) may not be fully developed, covering only the top of the penis. This can give the appearance of a "cap." It is very important that a child with this condition be seen by a doctor before undergoing circumcision. This extra skin can be used to repair the urethra during surgery.
• Chordee: The penis may be bent downwards to some extent, rather than straight.
• Undescended testicles: Some boys may have this condition where one or both testicles remain in the scrotum, not descending into the scrotum.

What are the causes of Hypospadias?

In fact, doctors have not yet found the exact cause of hypospadias. However, they have identified several factors that increase the risk of this condition.

• Genetic link: If someone in the family (father, brother) has had this condition, there is a chance that the child will also have it.
• Maternal conditions during pregnancy:
• Mother's age over 35 at the time of pregnancy.
• The mother's body mass index (BMI) is greater than 30, which means obesity .
• It is suspected that fertility treatment, especially hormones such as progesterone, which are given to maintain the pregnancy, may have an effect.
• Smoking during pregnancy.
• Exposure to certain chemicals or pesticides during pregnancy.

How is it treated?

The best and most successful treatment for hypospadias is surgery . This surgery is usually performed when the child is between 6 and 12 months old . There are several reasons for performing surgery at this age.

• It is safe to give general anesthesia to a child at this age.
• It is easy to care for the wound after surgery.
• The child will have no memory of this.

The surgery is usually performed by a pediatric urologist . The surgery has several main goals:

1. Straightening the penis: If there is a `chordee` condition, the penis is straightened by correcting the bending.

2. Reconstruction of the urethra: The incomplete urethra is made into a complete tube, bringing the urethral opening to the tip of the penis. This may involve using a piece of tissue taken from the child's own foreskin.

3. Skin reshaping: The skin of the penis is reshaped beautifully. Often, circumcision is performed at the same time as this surgery.

After surgery, a small tube (catheter) may be temporarily placed to drain urine until the urethra heals. This will be removed by the doctor in a week or two.

Are there any complications that may occur after surgery?

As with any surgery, there are risks and complications that can occur with this surgery, but these are very rare.

• Urethrocutaneous fistula: A small hole forms between the newly formed urethra and the skin, which can cause urine to leak.
• Urethral stricture: A scar can cause the urethra to become blocked.
• Recurrent curvature: The penis may curve downward again after some time after surgery.

If this happens, another minor surgery may be needed to correct it, but many children have very successful results with a single surgery.

How should I take care of the baby after surgery?

It is very important to take good care of your child after surgery. Follow the doctor's instructions exactly.

• Cleanliness: Keep the wound area as clean and dry as possible. Wash your hands thoroughly with soap and water before changing the diaper.
• Bathing: Do not bathe in a tub until your doctor tells you to. Sponge-bath. After the tube is removed, you can bathe normally.
• Avoid pressure: Do not place the baby on his stomach. Do not give him toys that sit with his legs spread out (rocking horse, jumper) for a few weeks.
• Swelling and discoloration: It is normal for the penis to be swollen and have a blue/purple color after surgery. This will gradually subside over a month or two.

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

If a problem arises after surgery, it is important to act quickly.

Hypospadias, Male Child Diseases, Birth Defects, Urethral Tube, Surgery, Child Health, Chordee