Hypospadias is a birth defect in which the opening of the urethra is not at the tip of the penis. Instead, the opening may be located anywhere along the underside of the penis, or even on the scrotum. Hypospadias is the most common birth defect of the male urinary tract, affecting about 1 in 200 boys.

Hypospadias repair surgery is a surgical procedure that is used to correct the opening of the urethra. The type of surgery that is performed will vary depending on the severity of the hypospadias. In some cases, a simple procedure may be performed to move the opening of the urethra to the tip of the penis. In other cases, a more complex procedure may be necessary to reconstruct the penis.

Hypospadias repair surgery is typically performed when the boy is an infant or young child. The surgery is usually successful, and most boys who have hypospadias repair surgery go on to have normal urinary and sexual function.

Here are some of the risks of hypospadias repair surgery:
⦁ Infection: There is a small risk of infection after any surgery.
⦁ Scarring: There may be some scarring at the site of the surgery.
⦁ Nerve damage: There is a small risk of nerve damage during surgery.
⦁ Recurrent hypospadias: In rare cases, the opening of the urethra may not heal properly after surgery, and the hypospadias may recur.

If you are considering hypospadias repair surgery for your child, it is important to talk to your doctor about the risks and benefits of the surgery. You should also make sure that you choose a surgeon who is experienced in performing hypospadias repair surgery.

Hypospadias repair surgery is a surgical procedure performed to correct hypospadias, a congenital condition where the opening of the urethra (the tube that carries urine from the bladder out of the body) is located on the underside of the penis instead of at the tip. The goal of the surgery is to reposition the urethral opening to the tip of the penis and to reconstruct the surrounding tissue to create a more normal appearance and function.

The surgical procedure for hypospadias repair typically involves the following steps:
⦁ Incision: The surgeon makes an incision to access the affected area, usually on the underside of the penis.
⦁ Urethral Reconstruction: The urethra is reconstructed and repositioned to allow for proper urine flow through the newly created opening at the tip of the penis. This may involve using tissue grafts or flaps to create a tube-like structure for the urethra.
⦁ Skin Closure: The surrounding skin is repositioned and closed to cover the newly reconstructed urethra and create a more normal appearance.
⦁ Additional Procedures: In some cases, additional procedures may be performed during the surgery to correct any associated abnormalities, such as curvature of the penis (chordee) or penile straightening.

After the surgery, the patient may be required to use a catheter to drain urine temporarily while the urethral repair heals. Follow-up care is important to monitor healing, ensure proper urine flow, and address any complications or concerns.

It’s important to consult with a skilled pediatric urologist or a urologist experienced in hypospadias repair to evaluate the individual case and determine the most appropriate surgical approach. The specific technique used may vary depending on the severity of the hypospadias and the individual’s unique anatomy. The surgeon will provide guidance on the surgical plan, expected outcomes, and post-operative care.


Hypospadias is a congenital condition where the opening of the urethra (the tube that carries urine from the bladder to the outside of the body) is located on the underside of the penis instead of at the tip. This condition occurs during fetal development when the urethral tube does not fully close, resulting in the abnormal placement of the urethral opening.

Key details about hypospadias include:

  1. Variability in Severity:
    • Hypospadias can vary in severity. The urethral opening may occur anywhere along the underside of the penis, from near the tip to the scrotum.
  1. Incidence:
    • Hypospadias is one of the most common congenital anomalies of the male genitalia, affecting approximately 1 in 200 to 1 in 300 live male births.
  1. Associated Conditions:
    • In some cases, hypospadias may be associated with other congenital conditions, such as chordee (a downward curvature of the penis), undescended testicles, or inguinal hernia.
  1. Developmental Factors:
    • The exact cause of hypospadias is not always known, but genetic and hormonal factors during fetal development are believed to play a role.
  1. Diagnosis at Birth:
    • Hypospadias is typically diagnosed at birth during a physical examination. The healthcare provider assesses the location of the urethral opening and evaluates any associated conditions.
  1. Early Treatment:
    • Surgical correction is the primary treatment for hypospadias. While the surgery is often performed in early childhood, the timing depends on factors such as the severity of the condition and the child’s overall health.
  1. Surgical Techniques:
    • Hypospadias repair surgery involves repositioning the urethral opening to the tip of the penis, correcting any penile curvature (chordee), and reconstructing the urethral tube. Surgical techniques may vary based on the specific characteristics of the condition.
  1. Multidisciplinary Care:
    • The management of hypospadias often involves a multidisciplinary team, including pediatric urologists, surgeons, and other healthcare professionals. The goal is to ensure comprehensive care and address any associated concerns.
  1. Long-Term Outcomes:
    • Most individuals who undergo hypospadias repair surgery experience successful outcomes. However, long-term follow-up may be necessary to monitor for potential complications or cosmetic issues.
  1. Psychosocial Considerations:
    • Addressing psychosocial aspects, including the child’s and family’s emotional well-being, is an important aspect of managing hypospadias. Support from healthcare providers and counseling may be beneficial.

Hypospadias is a treatable condition, and with timely and appropriate medical care, individuals with hypospadias can lead healthy and fulfilling lives. Regular follow-up with healthcare professionals is important to monitor development and address any ongoing concerns.


Repair surgery

“Repair surgery” is a broad term that encompasses various surgical procedures conducted to correct or restore the normal function and structure of a particular organ, tissue, or body part. The details of repair surgery depend on the specific condition or injury being addressed. Here are some key aspects:

  1. Purpose:
    • Repair surgery is performed to correct abnormalities, defects, injuries, or malfunctions in the body. It aims to restore normal anatomy and function.
  2. Types of Repair Surgery:
    • Repair surgeries can include a wide range of procedures across different medical specialties, such as orthopedic surgery, plastic surgery, urological surgery, cardiac surgery, and more.
  3. Orthopedic Repair:
    • In orthopedic surgery, repair procedures may involve fixing fractures, ligament or tendon injuries, joint dislocations, or other musculoskeletal issues.
  4. Plastic and Reconstructive Repair:
    • Plastic and reconstructive surgery may include repairing tissue defects caused by trauma, burns, or congenital conditions. This can involve skin grafts, flap surgery, and other techniques to restore appearance and function.
  5. Urological Repair:
    • Urological repair surgery addresses conditions affecting the urinary tract and reproductive organs. Examples include repairing urethral strictures, correcting hypospadias, or treating conditions affecting the bladder.
  6. Cardiac Repair:
    • Cardiac surgery may involve repairing heart valves, arteries, or congenital heart defects to restore normal cardiac function.
  7. Vascular Repair:
    • Vascular surgery focuses on repairing blood vessels affected by conditions such as aneurysms, blockages, or injuries.
  8. Gastrointestinal Repair:
    • Gastrointestinal surgery may involve repairing or removing parts of the digestive tract affected by conditions such as hernias, tumors, or inflammatory diseases.
  9. Neurosurgical Repair:
    • Neurosurgery includes procedures to repair or remove abnormal structures in the nervous system, such as tumors, herniated discs, or malformations.
  • Trauma Repair:
    • Emergency surgery to repair injuries sustained from trauma, such as fractures, internal organ injuries, or lacerations.
  • Minimally Invasive Techniques:
    • Many repair surgeries today utilize minimally invasive techniques, such as laparoscopy or arthroscopy, to reduce recovery time and minimize scarring.
  • Preoperative and Postoperative Care:
    • Comprehensive care includes preoperative assessments, surgery planning, the actual surgical procedure, and postoperative monitoring and rehabilitation.
  • Rehabilitation:
    • Depending on the type of repair surgery, rehabilitation and physical therapy may be essential for optimal recovery and functional restoration.
  • Patient Education:
    • Patient education is a crucial aspect, helping individuals understand the purpose of the surgery, potential risks, expected outcomes, and postoperative care requirements.

It’s important to note that the details of repair surgery vary widely based on the specific medical condition being addressed and the chosen surgical approach. Patients should consult with their healthcare providers to receive personalized information regarding their particular surgical procedure.

Urethral reconstruction

Urethral reconstruction, also known as urethroplasty, is a surgical procedure performed to repair or reconstruct the urethra, the tube that carries urine from the bladder to the external opening. This procedure is commonly employed to address conditions such as urethral strictures (narrowing of the urethra), hypospadias, and other congenital or acquired abnormalities. Here are key details about urethral reconstruction:

  1. Urethral Strictures:
    • Urethral strictures are abnormal narrowing of the urethra, often caused by scarring from inflammation, injury, or infection. Urethroplasty aims to widen the narrowed segment and restore normal urethral function.
  2. Hypospadias Repair:
    • Urethral reconstruction is used to correct hypospadias, a congenital condition where the urethral opening is located on the underside of the penis instead of at the tip.
  3. Types of Urethroplasty:
    • There are various techniques for urethroplasty, and the choice of procedure depends on factors such as the location and length of the stricture, the presence of associated conditions, and the surgeon’s expertise. Common techniques include substitution grafts, flaps, and excision and primary anastomosis.
  4. Grafts and Flaps:
    • Grafts involve using tissue from another part of the body (autograft) or synthetic material to reconstruct the urethra. Flaps involve transferring nearby tissue with its blood supply to the affected area.
  5. Excision and Primary Anastomosis:
    • In this technique, the narrowed portion of the urethra is removed (excised), and the healthy ends are reconnected (primary anastomosis) to create a wider, unobstructed passage.
  6. Preoperative Assessment:
    • Before urethral reconstruction, a thorough evaluation is conducted, including imaging studies, urethral dilations, and assessments of the stricture’s length and location.
  7. Anesthesia:
    • Urethroplasty is typically performed under general anesthesia, and in some cases, local anesthesia may be used.
  8. Surgical Approach:
    • The surgical approach may vary, including open surgery or minimally invasive techniques like endoscopic procedures. The choice depends on the complexity of the stricture and the surgeon’s preference.
  9. Postoperative Care:
    • Following urethral reconstruction, patients may require a temporary urinary catheter to assist with urine drainage during the initial healing phase. Postoperative care includes monitoring for complications, such as infection or stricture recurrence.
  • Recovery and Rehabilitation:
    • Recovery times vary based on the complexity of the procedure and the patient’s overall health. Rehabilitation may include follow-up appointments, urodynamic testing, and potentially physical therapy.
  • Success Rates:
    • Urethroplasty has generally high success rates, with many patients experiencing improved urinary function and a reduced risk of recurrent strictures.
  • Complications:
    • While urethroplasty is considered a safe and effective procedure, complications can include infection, bleeding, stricture recurrence, and changes in urinary or sexual function.

Urethral reconstruction is a specialized procedure performed by urologists with expertise in genitourinary surgery. The success of the surgery often depends on the specific characteristics of the stricture and the chosen surgical technique. Patients should consult with their healthcare providers to discuss the potential risks and benefits based on their individual case.

Genital reconstruction

Genital reconstruction, also known as gender-affirming or gender confirmation surgery, is a series of surgical procedures that aim to modify the genitalia to align with an individual’s affirmed gender identity. These procedures are often sought by transgender individuals as part of their transition. The specific surgeries performed depend on whether an individual is undergoing male-to-female (MTF) or female-to-male (FTM) genital reconstruction. Here are details for each:

  1. Male-to-Female (MTF) Genital Reconstruction:
  • Vaginoplasty: The primary surgery for MTF individuals involves the creation of a neovagina. This procedure typically includes:
    • Penile inversion technique, where the penile skin is used to create the vaginal lining.
    • Clitoroplasty to create a clitoris.
    • Labiaplasty to form labia minora and majora.
  • Orchiectomy: Removal of the testicles is often performed before or in conjunction with vaginoplasty.
  • Vulvoplasty: Some individuals may choose to undergo additional procedures, such as vulvoplasty, to enhance the external appearance of the genitalia.
  1. Female-to-Male (FTM) Genital Reconstruction:
  • Phalloplasty: The primary surgery for FTM individuals involves the construction of a neophallus. Different techniques include:
    • Radial forearm flap: Using skin and tissue from the forearm.
    • Anterolateral thigh flap: Using skin and tissue from the thigh.
  • Metoidioplasty: An alternative to phalloplasty, metoidioplasty involves releasing the ligaments that restrict the clitoral growth achieved through hormone therapy. It may include urethral lengthening and scrotoplasty.
  • Scrotoplasty: Creation of a scrotum to house testicular implants.
  • Urethral Lengthening: In some cases, surgery may be performed to extend the urethra to the tip of the neophallus, allowing for standing urination.
  • Testicular Implants: Silicone or saline-filled testicular implants can be placed in the scrotum to provide a more masculine appearance.
  • Penile Prosthesis: Some individuals may choose to have a penile prosthesis inserted to achieve erectile function.

General Considerations:

  • Hormone Therapy: Many individuals undergo hormone therapy before and after genital reconstruction to achieve secondary sex characteristics consistent with their affirmed gender.
  • Psychological Assessment: Prior to surgery, individuals typically undergo psychological assessments to ensure they are well-prepared for the physical and emotional aspects of the procedures.
  • Postoperative Care: Recovery times vary, and postoperative care includes follow-up appointments, dilation routines (for MTF individuals), and ongoing support.
  • Complications: As with any surgery, there are potential risks and complications. These may include infection, scarring, loss of sensation, and, in rare cases, surgical revisions.

Genital reconstruction is a personal and significant aspect of gender affirmation for many transgender individuals. The decision to undergo these surgeries is highly individual, and individuals considering these procedures often work closely with a multidisciplinary healthcare team, including surgeons, psychologists, and endocrinologists, to ensure comprehensive care and support throughout the process.


Penile curvature

Penile curvature, medically known as Peyronie’s disease, is a condition characterized by the development of fibrous scar tissue (plaque) in the erectile tissue of the penis. This plaque can cause the penis to bend or curve during an erection, leading to pain and potential difficulties with sexual activity. Here are details on penile curvature:

  1. Causes:
    • The exact cause of Peyronie’s disease is not fully understood, but it is believed to result from microtrauma or injury to the penis, leading to the formation of scar tissue.
  2. Symptoms:
    • The primary symptom is an abnormal curvature or bending of the penis during an erection. Other symptoms may include pain, tenderness, and the development of palpable plaques or lumps.
  3. Onset and Progression:
    • Peyronie’s disease can develop gradually, and the severity of symptoms can vary. In some cases, the curvature may improve over time, while in others, it may worsen.
  4. Diagnosis:
    • A healthcare provider can diagnose penile curvature based on a physical examination, medical history, and, in some cases, imaging studies such as ultrasound. Blood tests may be conducted to rule out underlying conditions.
  5. Natural History:
    • Peyronie’s disease may exhibit a variable and unpredictable course. While some individuals experience stable or improving conditions, others may face worsening symptoms.
  6. Peyronie’s Plaque:
    • The fibrous plaque that forms in Peyronie’s disease can occur on the top or bottom of the penis. This plaque can prevent the affected part of the penis from expanding properly during an erection, causing the curvature.
  7. Pain and Discomfort:
    • Pain and discomfort may accompany penile curvature, particularly during erections or sexual activity. The severity of pain can vary among individuals.
  8. Impact on Sexual Function:
    • Penile curvature can lead to difficulties with sexual intercourse, making certain positions uncomfortable or challenging. It may also contribute to anxiety and stress related to sexual performance.
  9. Treatment Options:
    • Treatment approaches for Peyronie’s disease include:
      • Observation: In cases where symptoms are mild and not causing significant distress, observation without intervention may be recommended.
      • Medications: Oral medications or injectable drugs may be prescribed to manage pain or reduce the progression of the condition.
      • Surgery: Surgical options, such as plaque incision or grafting, may be considered in severe cases or when conservative measures are ineffective.
    • Psychosocial Impact:
      • Peyronie’s disease can have a psychosocial impact on individuals, affecting self-esteem and intimacy. Seeking support from healthcare professionals and, if needed, mental health experts is crucial.

Individuals experiencing symptoms of penile curvature or Peyronie’s disease should consult with a urologist or healthcare provider for an accurate diagnosis and appropriate management. The choice of treatment depends on the severity of symptoms, the impact on sexual function, and the individual’s overall health.

Chordee correction

Chordee correction is a surgical procedure performed to address chordee, a condition characterized by an abnormal downward curvature of the penis during an erection. Chordee is often associated with hypospadias, a congenital condition where the opening of the urethra is located on the underside of the penis instead of at the tip. Chordee correction may be performed as part of a comprehensive approach to address both the curvature and the underlying hypospadias. Here are details on chordee correction:

  1. Diagnosis:
  • Chordee is typically diagnosed during a physical examination, especially when evaluating individuals with hypospadias. Diagnostic imaging, such as urethrography or ultrasound, may be used to assess the extent of the chordee and associated abnormalities.
  1. Timing of Correction:
  • Chordee correction is often performed in conjunction with hypospadias repair, and the timing of the surgery depends on the specific case and the age of the patient. Surgical intervention may be recommended during early childhood.
  1. Chordee Release:
  • The primary goal of chordee correction is to release or lengthen the tissue (fibrous bands or tethering structures) causing the downward curvature of the penis. This may involve incisions or dissection to release the tension in the tissues.
  1. Tissue Grafts:
  • In some cases, tissue grafts or flaps may be used to cover and support the area where the chordee was released. These grafts may be taken from the patient’s own tissue or, in some instances, from donor sources.
  1. Urethral Reconstruction:
  • Chordee correction is often performed in conjunction with urethral reconstruction, especially when associated with hypospadias. Urethral repair involves repositioning the urethral opening to the tip of the penis.
  1. Realigning Structures:
  • Chordee correction may involve realigning structures to allow for a straighter and more functional penis during an erection. This may include adjusting the position of the corpora cavernosa or other relevant structures.
  1. Consideration of Circumcision:
  • In some cases, circumcision may be performed concurrently with chordee correction, depending on individual factors and the surgeon’s approach.
  1. Postoperative Care:
  • After surgery, patients are monitored for proper healing, and postoperative care includes follow-up visits to assess the outcomes. In cases of hypospadias and chordee correction, a urinary catheter may be temporarily used to assist with urine drainage during the initial healing period.
  1. Multidisciplinary Care:
  • Chordee correction is typically performed by a urologist or a surgeon with expertise in pediatric urology. The management may involve a multidisciplinary team, including pediatric surgeons, anesthesiologists, and nursing staff.
  1. Long-Term Outcomes: – The long-term outcomes of chordee correction are generally positive, with many individuals experiencing improved penile function and aesthetics. However, ongoing follow-up may be necessary to monitor for any potential complications or the need for additional procedures.

Chordee correction is an integral part of the overall management of hypospadias and aims to ensure normal penile development and function. The specific surgical techniques used may vary based on the severity of the chordee and associated conditions. Patients and their families should consult with healthcare providers for personalized information and guidance.

Grafts or flaps

Grafts and flaps are surgical techniques involving the transplantation of tissue from one part of the body (or, in some cases, from a donor source) to another to repair or reconstruct damaged or deficient areas. These techniques are commonly employed in various medical specialties, including plastic surgery, urology, and reconstructive surgery. Here are details on grafts and flaps:

  1. Grafts:
  • Definition: A graft involves the transplantation of tissue from one location (the donor site) to another (the recipient site) without its direct blood supply.
  • Types:
    • Autograft: Tissue taken from one part of the patient’s own body.
    • Allograft: Tissue transplanted from a donor of the same species.
    • Xenograft: Tissue taken from a different species.
    • Synthetic Graft: Laboratory-made materials, such as silicone or Dacron.
  • Applications:
    • Skin grafts are common for reconstructing damaged skin, especially after burns or trauma.
    • Autografts are preferred due to lower risks of rejection.
  1. Flaps:
  • Definition: A flap involves the transfer of tissue along with its blood supply from one site to another. This maintains the blood circulation and enhances tissue survival.
  • Types:
    • Local Flap: Tissue transferred from a nearby area.
    • Regional Flap: Tissue transferred from a neighboring region with a similar blood supply.
    • Free Flap: Tissue completely detached from its original site, with blood vessels reattached at the recipient site (microvascular surgery).
  • Applications:
    • Used in reconstructive surgeries to repair large defects, such as those resulting from tumor removal, trauma, or congenital anomalies.
    • Commonly employed in plastic and reconstructive surgery, including breast reconstruction and facial reconstruction.
  1. Indications:
  • Grafts: Used for relatively smaller defects, where the absence of a direct blood supply is acceptable.
  • Flaps: Preferred for larger defects or areas where maintaining blood supply is crucial for tissue survival.
  1. Surgical Technique:
  • Grafts: The donor tissue is harvested and placed onto the recipient site, where it adheres and gradually incorporates.
  • Flaps: The tissue, along with its blood vessels, is carefully dissected and moved to the recipient site. Microsurgical techniques are often used for precise vessel anastomosis.
  1. Healing and Integration:
  • Grafts: Healing involves the gradual integration of the graft with the surrounding tissues.
  • Flaps: Integration is more rapid due to the preserved blood supply, resulting in better overall tissue survival.
  1. Risks and Complications:
  • Grafts: Risks include graft failure, infection, and poor cosmetic outcomes.
  • Flaps: While more complex, flaps generally have better success rates but may still be susceptible to complications such as partial or complete flap loss.
  1. Postoperative Care:
  • Grafts: Monitoring for signs of graft failure, proper wound care, and follow-up assessments.
  • Flaps: Intensive postoperative monitoring, including assessing vascular perfusion and ensuring flap viability.

Grafts and flaps are versatile surgical techniques that play a crucial role in restoring form and function to various areas of the body. The choice between grafts and flaps depends on factors such as the size and location of the defect, the condition of the surrounding tissues, and the overall goals of the reconstructive procedure.

Pediatric urology

Pediatric urology is a specialized field of medicine that focuses on the diagnosis and treatment of urological conditions in children. Urology involves the study and management of disorders related to the urinary tract and male reproductive system. Pediatric urologists are trained to address a wide range of urological issues specific to infants, children, and adolescents. Here are key details on pediatric urology:

  1. Urological Conditions in Children:
  • Pediatric urologists diagnose and treat various conditions, including:
    • Congenital anomalies of the kidneys and urinary tract.
    • Vesicoureteral reflux (abnormal flow of urine from the bladder back into the ureters).
    • Hydronephrosis (enlargement of the kidneys due to urine backup).
    • Undescended testicles.
    • Ureteropelvic junction obstruction.
    • Bladder dysfunction.
    • Pediatric kidney stones.
  1. Multidisciplinary Approach:
  • Pediatric urology often involves collaboration with other specialists, such as neonatologists, pediatric nephrologists, pediatric surgeons, and geneticists, to provide comprehensive care.
  1. Neonatal Urology:
  • Pediatric urologists may be involved in the care of newborns with congenital urological abnormalities, including antenatal hydronephrosis and other conditions detected through prenatal imaging.
  1. Surgical Interventions:
  • Pediatric urologists perform surgical procedures tailored to the unique anatomical and developmental considerations of children. Common surgeries include:
    • Hypospadias repair.
    • Orchiopexy (fixation of undescended testicles).
    • Pyeloplasty (repair of ureteropelvic junction obstruction).
    • Circumcision.
    • Bladder reconstruction.
  1. Minimally Invasive Surgery:
  • Pediatric urologists increasingly utilize minimally invasive techniques, such as laparoscopy and robotic-assisted surgery, to perform complex procedures with smaller incisions, reduced postoperative pain, and quicker recovery times.
  1. Bedwetting and Voiding Dysfunction:
  • Pediatric urologists assess and manage conditions related to voiding dysfunction, enuresis (bedwetting), and urinary incontinence in children.
  1. Neurogenic Bladder:
  • Children with neurogenic bladder dysfunction due to conditions like spina bifida or spinal cord injuries may require specialized care from pediatric urologists.
  1. Transitional Care:
  • Pediatric urologists often work with adolescent patients, providing transitional care as they move into adulthood. This may involve addressing issues such as reproductive health and sexual function.
  1. Genetic Counseling:
  • In cases of congenital urological anomalies with a genetic component, pediatric urologists may collaborate with genetic counselors to provide families with information about the condition’s hereditary aspects.
  1. Patient and Family Education: – Pediatric urologists play a crucial role in educating patients and their families about the diagnosis, treatment options, and long-term management of urological conditions. This includes discussions on lifestyle modifications, medications, and surgical interventions.

Pediatric urology requires specialized training and expertise to address the unique anatomical, developmental, and emotional needs of children with urological conditions. The field encompasses a wide range of disorders, and early diagnosis and intervention are essential for optimal outcomes. Families with children experiencing urological issues should seek care from pediatric urologists who can provide comprehensive and compassionate management.