May 4, 2017

Hypospadias Surgery In Teens, Young Adults And Older People

Hypospadias surgery is a medical procedure that aims to correct abnormalities in the male genitalia. Hypospadias is a condition that occurs when the urethral opening is not at the tip of the penis, but rather on the underside of the penis or near the scrotum. This condition can cause discomfort during urination and other health risks as the patient grows older.

Furthermore, hypospadias can also cause the fold of skin on top of the penis to develop abnormally, affecting the appearance of the penis. Hypospadias surgery aims to address these concerns by creating a normal excreting urethra, improving the penile cosmesis, and minimising complications. In this blog post, we’ll explore the causes, symptoms, and risks associated with hypospadias, as well as the different surgical options available to treat this condition.

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A] Challenges Of Hypospadias Surgery in Teens & Young Adults

Hypospadias in teens is a common congenital condition in boys that is typically repaired in infancy. Which is why, typically, hypospadias repairs in children are done within 6 months to 1 year of age. Delayed treatment can lead to serious issues later in life. However, finding skilled surgeons for older patients can be challenging as most specialists focus on newborns. This can make it harder for teens and young adults to receive proper care.

Many patients require hypospadias surgery later in life for various reasons. However, older patients may face more complications such as swelling, bleeding, longer healing time, and increased pain levels. Performing the surgery on older patients can also be more difficult for the surgeon, and can increase the risk of complications.

What complications might arise if hypospadias is not treated in time? If hypospadias is left untreated, it can lead to several complications, including difficulty using the toilet, an abnormal appearance of the penis, and reproductive issues.

B] Why Do Teens And Young Adults Require Hypospadias Surgery?

Teens and young adults may require hypospadias surgery for various reasons. Some individuals may not have undergone the surgery during infancy and are considered primary cases. Others may have had a previous surgery that was unsuccessful, resulting in complications or a need for further corrective procedures. Additionally, some individuals may experience functional or cosmetic issues that require surgical intervention.

C] Stages Of Hypospadias Repair

The stages of hypospadias repair surgery vary depending on the severity of the condition, but generally involve the following steps:

The surgery may be done in one stage or in multiple stages, depending on the severity of the hypospadias and the surgeon’s preference. The exact procedure and number of stages needed will be determined by the pediatric urologist during the consultation.

D] What Are The Risk Factors Of Hypospadias?

Many male infants are born with hypospadias, and there are several possible reasons for this congenital condition.

Family history: Newborn boys who have a family history of hypospadias are at a higher risk of being diagnosed with the condition.
Genetical variations: During fetal development, certain genes can undergo variations that can disrupt the hormones responsible for the formation of male genitalia.
Age of the mother: Male children are more likely to be born with hypospadias when their mothers are aged 35 or older, according to research.
Exposure to certain substances during pregnancy: Exposure to industrial chemicals, secondhand cigarette smoke, and pesticides during pregnancy can increase the likelihood of children developing hypospadias.
Premature birth or twin: A male child who is born prematurely or as a twin has a higher chance of being diagnosed with hypospadias.

E] What Are The Treatments Available For Hypospadias In Teens And Adults?

Hypospadias can only be treated through surgery performed by a qualified specialist called a hypospadiologist, who specializes in the care for hypospadias patients. Patients should take care when selecting a surgeon for the procedure, especially in the case of adults, as the surgery requires careful planning and should only be performed by an experienced expert in the field.

Age Group	Hypospadias	Surgical Option	Second Opinion
Teens	Birth defect causing urethral opening on underside of penis.	Urethroplasty to correct the position of the urethral opening	Yes
Young Adults	Congenital condition where urethra opens on underside of penis.	Surgical reconstruction to reposition the urethral opening to the tip of the penis.	Yes
Older People	Pre-existing hypospadias or complications from previous surgeries.	Urethroplasty or other corrective surgeries depending on individual circumstances.	Depends on individual case and surgeon’s discretion.

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F] Bottom line

Hypospadias surgery in older children and young adults poses unique challenges for both the surgeon and patient. After surgery, older patients may experience more bleeding, swelling, and pain than younger patients. Additionally, their healing process may be slower due to decreased healing capabilities. Therefore, it is crucial to have a trained hypospadiologist and Pediatric Surgeon to perform the surgery and minimize future complications.

If you require corrective surgery for hypospadias during your teenage or adult years, it’s crucial to approach the procedure with careful planning and seek advice from a qualified specialist like Dr. Gursev Sandlas, who has years of experience in handling such cases. By consulting with an expert in the field, you can ensure that the surgery is carried out with the utmost care and precision, leading to better outcomes and an improved quality of life.

By Dr. Gursev Sandlas