Surgical procedures for urethral dysfunction / hypospadias

A urethral dysfunction (hypospadias) is congenital. It is a fairly common malformation and occurs in about one in 125 male new-borns.

Urethral hypospadias occurs when the urethra does not open at the tip of the penis, but slightly behind it. In this case, the opening is usually location from the glans to the front shaft of the penis. More rarely, the opening is located in the middle and posterior shaft of the penis. The opening can also be in the perineal area, though this is very rare. Accompanying malformations, such as a curvature of the penis and an apron-like foreskin, are possible as a result of hypospadias.

Hypospadias is not directly hereditary, but the risk of urethral dysfunction is increased if the father or brother also has it.

Hypospadias does not usually cause any issues in infancy. Treatment for shifting the urethral opening ot the tip of the penis and correcting any accompanying malformations, such as penile curvature or split foreskin, is always surgical. Minimal forms of hypospadias do not require surgical correction from a functional point of view. The extent to which cosmetic factors are taken into account in a request for correction must be clarified on an individual basis.

The ideal age for surgical correction is between the ages of 1 and 2. However, surgery is also possible at a later age.

Hypospadias is a visual diagnosis. A physical examination is supplemented by an ultrasound examination to rule out other accompanying malfunctions that sometimes occur. These include undescended testicles or other malfunctions of the urinary tract. If abnormalities are found, further examinations are necessary. The surgeon decides whether hormone treatment should be applied for a certain period of time before the procedure.

Different techniques are used depending on the location of the urethral opening. A surgeon experienced in hypospadias can offer the entire repertoire and achieve an optimal result with the appropriate surgical technique for different degrees of severity.

The procedure is performed under general anaesthesia. The duration of inpatient stay may vary depending on the surgical technique used and the difficulty of the reconstruction. The urine is drained via a bladder catheter, although an abdominal catheter may also be necessary. In most cases, hypospadias can be corrected in a single operation. If the hypoplasia is very pronounced, a two-stage procedure is necessary. Of course, the Goldstadt Private Clinic offers parent the possibility of accompanying the patient, including accommodation. The procedure is followed by outpatient check-ups after the patient is discharged.

In addition to the general risks of any operation, such as bleeding or fever, urethral fistulas and strictures may occur. All possible risks of the surgical intervention are discussed in a detailed explanatory discussion prior to the procedure.

Only through a broad wealth of experience can the multitude of possible surgical procedures available be used successfully. This is a prerequisite for minimising the risk of possible complications such as fistulas or stenosis. At the Goldstadt Private Clinic, these procedures are performed by private lecturer Dr. med. Jörg Seibold. He is the author of numerous scientific publications on the subject and is internationally renowned in the fields of reconstructive urology and paediatric urology. His over 20 years of experience in the field of reconstructive urology ensures optimal surgical results.