Do you know Hypospadias?

Hypospadias is a birth defect in boys in which the urethra is short and does not lead to the tip of the penis. The urethra can lead to the underside of the glans, the underside of the penis, the skin of the scrotum or even behind the scrotum. The severity of hypospadias can vary case by case. In addition, the skin on the bottom usually closed and sometimes lack a skin on the underside of the penis is. There is sometimes a mild to severe curvature of the erect penis.
Very rarely can one be so severe hypospadias, which after birth is not clear whether the child is a boy or a girl. This then in a specialized center to be sorted out urgently.

Hypospadias is not a rare disease: it affects 1 in 200 to 300 boys. In total this amounts to about 400 boys per year in the Netherlands.
The cause for the development of a hypospadias is generally unknown. The risk of hypospadias may be enhanced by including genetic factors, low birth weight of the child and / or some environmental factors (chemical substances with a weak effect of the female hormone estrogen).

Treatment
The only treatment for hypospadias is surgical. Only in very mild forms of hypospadias, with standing puddles just possible and where there is no curvature in erection, one can also choose to do nothing.
The goal of surgery is:

    the urethra extending to the glans
    any curvature to correct
    ensure that the penis at the top and bottom well covered with skin.

In short, the goal is that the penis is good both functionally (urinate standing erect and straight) as cosmetically good (looks neat).

The operation is preferably done at an age between 9 and 18 months. The main reason is that at this age the child is least cumbersome. If a child is older, much better because he has something "wrong" with his penis. Technically, the operation also age very little difference.

The duration of surgery is usually between 1.5 and 3.5 hours. This depends on the severity of the hypospadias. In enstige shapes can sometimes be selected to the correction of two operations to distribute at least half years in between.
Usually the surgery as an outpatient or short stay in hospital performed.
A hypospadias correction is certainly not a simple operation. Therefore this operation is preferably one experienced this (child-) urologist performed. These are active in most teaching hospitals and some large non-academic hospitals.

Sequelae
Unfortunately heals even the most experienced doctors the surgical site is not always perfect and can have complications that require additional surgery. Sometimes this happens shortly after surgery, sometimes after months or even years. The physician can and will tell you more about the surgery before being decided.
Some boys also suffer from psychological effects, especially after puberty, when they are sexually active (want to) be. As mentioned earlier, this risk is somewhat higher in older age at surgery, which rarely happens these days.