standard-title FAQ FOR PARENTS > 11-20 Frequently Asked Questions - For Parents

FAQ FOR PARENTS > 11-20

Frequently Asked Questions - For Parents

Frequently Asked Questions (FAQ)

Questions and answers about Hypospadias.

11. Will my son´s penis look “normal” after hypospadias-operation?

There is no surgery without a scar as surgery is done through an incision in the glans and the penis.

Surgeons try to limit incisions to the midline of the lower surface of the penis as these incisions heal with the best cosmetic results and in many cases may look like the normal “median raphe” that is normally present in the lower midline surface of the penis.

Luckily, most children (85 %) with glanular (grade1), distal (grade 2) and the majority of proximal (grade 3) hypospadias heal with minimal scar especially if the operation is done by an experienced surgeon but there is no guarantee. Occasionally, some children may heal with obvious unsightly scar that may require further surgery.

The other important fact is that the aim of hypospadias surgery is to correct the chordee (penile curvature) and to bring the urethral opening to the tip of the penis and to try to make the penis look near normal as much as is possible. The penis may “LOOK” a bit longer after surgery if the surgeon corrects the curvature carefully by removing the tethering bands and NOT by dorsal plication (Nesbit procedure and its modifications) which shortens the upper surface of the penis.

A short penis before surgery will remain short after surgery (especially in grade III b and IV).

12. Is the size of my son´s penis normal?

This is one of the most commonly asked questions.

According to several scientific studies, the size of the hypospadias penis is comparable to normal penis sizes in normal boys. Also, those studies showed that the sexual function in corrected hypospadias patients is similar to normal population (apart from severe forms of proximal and perineal hypospadias, Grade IIIb and Grade IV, which constitute less than 10 %of children with hypospadias).

13. Does Professor Hadidi personally operate on public patients as well or only private patients?

Professor Hadidi operates personally all hypospadias patients. Patients with private insurance are operated on in Emma Hospital. Patients with public insurance are operated on in Offenbach Hospital.

Professor Hadidi consults and examines all patients personally before surgery and follow up all his patients personally.

14. What is the procedure for patients outside Germany, who would like Professor Hadidi to operate on our son?

Please send an e-mail to Professor Hadidi with all details like child´s name and birth date, your address and telephone-number. There are two possibilities:

To have the operation done in Emma Klinik in Germany.

To have the operation done in your country. Professor Hadidi travels few times every year to several countries including Spain, Greece, Hungary, Romania and Egypt when there are enough patients to justify the travel.

15. When should the hypospadias-operation be performed?

Recent studies showed that the ideal time for hypospadias correction is between 3 and 18 months as the penis grows less than 1 cm during the first 3 – 4 years

16. Should we do any tests before surgery

In Grades I, II, IIIa,  when the child has no complaints or problems, there is no need to perform any tests before surgery. However, some hospitals prefer to do routine blood check, blood coagulation tests, urine analysis or ultrasound on the kidney and bladder.

In Grade IIIb and Grade IV blood check, blood coagulation tests, urine analysis or ultrasound on the kidney and bladder is recommended according to the doctor evaluation of each individual child.

17. When should we do chromosomal analysis (tests)?

In glanular and distal hypospadias (Grade I, II, III a) with both testes in the scrotum, this is not necessary.

In perineal hypospadias (Grade III b, Grade IV) or when hypospadias is associated with undescended testis and in patients suspected of having disorders of sexual development (DSD).chromosomal analysis is  important to accurately identify the gender of the child.

18. Should my son receive hormonal treatment before the hypospadias-operation?

Glanular and distal hypospadias and majority of proximal hypospadias do not need pre-operative hormonal treatment. Some surgeons prefer to use pre-operative hormonal treatment in the form of cream or injections in severe forms of proximal hypospadias. The drawback with hormonal treatment is that it does not affect the penis only but affects the whole body including bone growth and the effect of hormons on the penis is temporary (1 month after therapy).

Prof. Hadidi does not recommend to use pre-operative hormonal therapy as a routine because of its adverse effect on the body in general and because it alters the tissues of the penis and increases the chances of bleeding. However pre-operative hormonal therapy may be helpful in patients with Disorders of Sexual Development (DSD) or when the phallus is very small.

19. Is vaccination a contra-indication for surgery?

Vaccination makes the immune system weaker than normal for about a month. Therefore, it is recommended that the last vaccination should be at least one month before surgery and the next vaccination should be at least one month after surgery.

20. If my son develops running nose, diarrhea, cough, fever before surgery, does this affect the operation?

If the child has running nose only without fever or chest infection, the operation is performed as planned in our centre. Diarrhea in our centre does not postpone the operation. However, each hospital has different protocol of management.

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HYPOSPADIAS

Information about the Hypospadias-surgery

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PROF. DR. HADIDI’S BLOG

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General knowledge and information about hypospadias.

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