Hypospadias is a congenital defect in males in which The opening of the urethra is not at the tip of the penis. It occurs between weeks 8 and 14 of pregnancy. The abnormal opening of the urethra can be anywhere, from the area just below the tip of the penis to the scrotum.
Types of hypospadias
There are different degrees, some milder and others more serious. The type will depend on the location of the opening of the urethra:
- Balánico: The opening is near the head of the penis.
- Peneano: it is located in the body of the penis.
- Penoescrotal: the opening is located in the area where the penis joins the scrotum.
If it is not treated may cause problems later, such as difficulty urinating while standing or having sex.
Causes and risk factors
Although the cause of hypospadias is usually not known, it is believed that in most cases, It is caused by a combination of genes and other factors. Among these factors are the environmental elements with which the mother is in contact, her diet and certain medications used during pregnancy.
On the other hand, the risk of developing hypospadias is related to aspects such as:
- Family background.
- Genetics: Certain genetic variations can play an important role in the alteration of the hormones that stimulate the formation of the male genitalia.
- Age of the mother: Some research suggests that babies born to mothers over 35 may have a higher risk of having hypospadias.
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In most cases The opening is within the limits of the head of the penis. Less frequently it is located in the middle or at the base of the penis. Symptoms of hypospadias may include:
- Opening of the urethra outside the tip of the penis.
- Descending curvature of the penis.
- Hooded appearance of the penis because only the upper half is covered with the foreskin.
- Abnormal form of urination.
Generally, most babies with hypospadias They are diagnosed shortly after birth. However, if there is a slight displacement of the opening it can be more difficult to diagnose.
The treatment for hypospadias depends on the type of defect. In most cases, surgery will be needed to correct it and it is usually done between 3 months and 3 years of age. In some cases, surgery is done in stages. There are different surgical repairs such as:
- Place the opening in the correct place.
- Correct the curvature of the penis.
- Repair the skin surrounding the opening of the urethra.
Because the doctor may need prepuce skin for repair, It is not advisable to circumcise children with hypospadias. The surgery is performed on an outpatient basis, it is rarely necessary for the child to spend the night in the hospital.
However, surgical treatment it is not necessary if the defect does not affect normal urination standing, to sexual function or to the deposit of semen.
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The surgeon will use a piece of the foreskin or tissue from another part to create a tube that increases the length of the urethra. This will allow the urethra to flow into the tip of the penis.
Also, during surgery, a tube will be placed in the urethra to keep it in its new shape. This probe is usually removed 2 weeks after the intervention. If the repair is not done, problems may appear later such as:
- Difficulty controlling and directing the urine stream.
- Curve in the penis during erection.
- Decreased fertility
- Personal problems due to the appearance of the penis.
Most cases They have a good prognosis after the intervention. This is how the penis works with complete normality. In turn, surgery also improves its appearance.
They are recommended follow-up visits with the urologist after surgery. Likewise it will be advisable to make a view when reaching adolescence to check that everything is correct.