Surgery for urethral malformation / hypospadias

A urethral malformation (hypospadias) is congenital. It is a fairly common malformation and occurs in approximately every 125th newborn boy.

If the urethra does not open at the tip of the penis but before it, this is referred to as a urethral malformation (hypospadias). The openings are usually located in the area from the glans to the front of the penile shaft. Less frequently, the opening is located in the middle or rear part of the penile shaft. Very rarely, the opening may also be located in the perineal area. Attention must be paid to accompanying malformations, e.g. penile curvature and an apron-like foreskin.

There is no direct heritability, but the risk of a urethral malformation is increased if the father or a brother is affected.

Hypospadias usually causes no problems in infancy. Treatment to move the urethral opening to the tip of the penis and to correct any accompanying malformations such as penile curvature or a split foreskin is always surgical. From a functional point of view, minimal forms of hypospadias do not require surgical correction. The extent to which cosmetic aspects play a role in the desire for correction must be clarified individually.

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

Hypospadias is a visual diagnosis. A physical examination is supplemented by an ultrasound examination in order to rule out other accompanying malformations, as sometimes occur. These include, among others, undescended testicles or other malformations of the urinary tract. If abnormalities are found, further examinations are necessary. The experienced surgeon decides whether a hormone ointment should be applied for a certain period before the operation.

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

The operation is performed under general anaesthesia. The length of the inpatient stay can vary depending on the surgical technique used and the difficulty of the reconstruction. Urine is drained via a bladder catheter; an additional suprapubic catheter may also be necessary. In most cases, hypospadias can be corrected in a single operation. In very pronounced cases, a two-stage procedure is necessary. Of course, the Goldstadt Private Clinic offers parents the option of staying in the room as accompanying persons. Outpatient follow-up examinations take place after discharge.

In addition to the general risks of any operation, such as bleeding or fever, urethral fistulas and strictures can subsequently occur. All possible risks of the surgical procedure are discussed in a detailed consultation before the operation.

Only with a broad wealth of experience can the large number of possible surgical procedures be used successfully. This is a prerequisite for minimising the risk of possible complications (formation of fistulas or strictures). At the Goldstadt Private Clinic, these procedures are performed by Privatdozent Dr. med. Jörg Seibold. He is the author of numerous scientific publications on this subject and has an international reputation in the field of reconstructive urology and paediatric urology. His more than 20 years of experience in the field of reconstructive urology ensures optimal surgical results.