A little boy from Bangladesh takes a little bit of India with him: Successful Distal Penile Hypospadias Repair Surgery in Navi Mumbai

Posted on July 10, 2015 by Dr. A K Singal

We are privileged to care for children from across the world who come with their parents to our Hypospadias centre in Navi Mumbai, India looking for the best in Hypospadias surgery and treatment. The love and affection which we give to the kids is a mirror image of the trust and faith which family puts in us. It is the simple rule of medical care and cure.

Happy kids= happy parents = good results= happy surgeon who sleeps well. Our nurses and junior doctors almost adopt the kid as one of theirs and then play with the kid during recovery time and we see that with such a personalized care the kids recover after hypospadias surgery in no time.

Somebody said it aptly, “When you are happy the time flies very fast”. Hence, if everyone remains happy and in high spirits after a hypospadias surgery, time just disappears. Long journey to India and time spent here seems worthwhile.

The Email from Dhaka, Bangladesh:


Dear Sir,

Here is our testimony. As you know we are from Dhaka city in Bangladesh and when our son, baby Satyaki Sarkar, was born, he had a problem which the doctors named distal penile hypospadias. So when doctor told us about this problem we were very worried. We didn’t know what to do because we never heard the name of such type of problem. I searched in internet about the problem for best doctor for hypospadias. After searching internet we got the address of Dr. Arbinder Singal, Hypospadias specialist surgeon and Hypospadias Foundation in Navi Mumbai, India. We also watched the video of hypospadias repair surgery which they had uploaded related to surgery about hypospadias of a baby. We also studied the articles of Dr. Singal and others hypospadias surgeons around the world. After that we finally decided to do the hypospadias repair surgery in Navi Mumbai India, at MITR Hospital & Hypospadias foundation. We contacted with the authority of Hypospadias foundation for getting appointment. Ms. Emily Paul and Dr. Rajkumar Gupta arranged appointment for us in a cordial way.

Now it was time for hypospadias surgery. We met with Dr. Singal on 21st March. He appointed us on 23rd March for operation. We were so tensed about Satyaki’s operation. But Dr. Singal and his team were so cooperative that we forgot about all tensions and focused only on Satyaki’s operation. At last, on 23rd March, 2015, the hypospadias operation was done successfully without any problem. After having surgery we stayed in the hospital for one day and the next day they discharged us. After having surgery we felt that we came in the right place because my baby had no surgical pains. He recovered so quickly that we couldn’t imagine. We realized that best results are possible after hypospadias surgery.
We would like to specially mention about the nurses and staffs of hypospadias foundation. They were so cooperative, and cordial. They can manage the babies with hypospadias after surgery in a very caring and professional way.
Now my little boy is completely recovered and doing well without any problem. You may post the picture of my baby and us which you have to us. Because we think that this may help to realize the families that hypospadias problem may be solved through proper surgery. We also think that through our message and picture many families who are suffering from this problem will get new aspirations and hope.
At last we again want to give thanks to Dr. Singal and his team for doing this surgery in an excellent way. We wish success of this foundation in every step of its life.
With best regards

Sanjeev Kumar Sarkar
Father of Satyaki Sarkar
Dhaka, Bangladesh.

Dr A.K.Singal

Satyaki Sarkar after successful hypospadias surgery with his family and Dr Singal


Case Details: Master Satyaki had a coronal hypospadias, a variety of distal penile hypospadias. He did not have any chordee and his urethral plate was good quality. Hence, we elected to perform a TIP (Tubularised Incised Plate urethroplasty, also called Snodgrass repair). The surgery was completed in one hour’s time and Satyaki was allowed feeds two hours after surgery. He recovered well from anesthesia and surgery and was planned for discharge the next day. In the usual course of family living nearby, we could have sent him home the same day also but since the family had travelled all the way from Bangladesh we kept them in hospital for overnight observation and then they shifted to a nearby hotel. Hypospadias dressing and catheter was removed 5 days after surgery and a final examination done 10 days later showed everything to be well healed and Satyaki was passing urine very well from his new opening at the tip of penis. Now at three months after surgery, Satyaki continues to do well and surgical team is delighted with the outcome of surgery.

While most of families may be little concerned about sharing their personal details etc, Mr Sarkar was very gracious and himself offered to share pictures and details to lend authenticity to the story. He felt this will encourage the parents to think positively about hypospadias treatment in their children. Our endeavor at Hypospadias Foundation of providing good personal and surgical care to children stands fulfilled when we get testimonial and review emails like this one.

About Hypospadias Foundation:

Hypospadias Foundation is a centre of excellence for treatment of children and adults having hypospadias. The centre is located within MITR Hospital at Kharghar, Navi Mumbai India and is the best hospital for treatment and care for patients with hypospadias and associated problems including DSD. The team is led by Dr A.K.Singal, a renowned Pediatric urologist surgeon and an excellent hypospadias surgeon. He is supported by Dr Manish Dubey who helped Dr Singal start Hypospadias Foundation and is himself a renowned Urologist. Every year more than 200 kids and adults travel to Navi Mumbai for care and treatment of Hypospadias. If you wish to contact us, you can write to us at hypospadiasfoundationindia@gmail.com or call Dr Rajkumar, Coordinator for Hypospadias Foundation at +919821261448 between 10am-5pm, India time.

You can also click here and fill up the contact form and we will answer your query as soon as possible

Watch Video of Distal penile Hypospadias repair procedure by Dr A.K.Singal

Watch Video of proximal penile hypospadias procedure by Dr A.K.Singal

Watch Video of severe scrotal hypospadias repair by Dr A.K.Singal

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Posted in Hypospadias surgeon India,Success Stories,Uncategorized | Posted by Dr. A K Singal | Posted on July 10, 2015 by Dr. A K Singal | Tagged after hypospadias surgery, best hypospadias hospital, flap repair for hypospadias, hypospadias clinic in india, hypospadias surgeon bhopal, hypospadias surgeon in MP, hypospadias surgeon India, hypospadias surgery india, one stage surgery for hypospadias, onlay flap urethroplasty, onlay island flap hypospadias repair, results of hypospadias, results of scrotal hypospadias surgery, scrotal hypospadias, scrotal hypospadias repair, scrotal hypospadias surgery, severe hypospadias, single stage urethroplasty, urethroplasty for scrotal hypospadias

Cashless or Mediclaim Coverage of Hypospadias repair surgery and treatment by Insurance Companies in India

Posted on May 10, 2015 by Dr. A K Singal

Hypospadias is a urinary birth defect in which the urinary opening is on the underside of penis rather than being at the tip of the penis. In more than 50% of patients with hypospadias, the penis is also bent downwards – this penis curvature is called chordee. Hypospadias affects 1/150 newborn boys and hence more than 1 lakh (1,00,000) kids are born in India with hypospadias every year. Worldwide the incidence has increased probably due to increasing burden of chemicals and pollutants which act as endocrine disruptors (chemicals which block male hormone action) and have contributed to an increasing incidence of hypospadias.

Most of these kids except the ones with very minor glanular hypospadias without chordee will need surgery. The surgery is ideally done between 6months-18 months for age of the child was born with good weight and full pregnancy, if the child is underweight or preterm or has any other major anomalies then it may be better to wait till the child is about 3 years of age.

When and how does hypospadias happen?

Hypospadias results from defective formation of urinary tube during 8-12 weeks of pregnancy and hence if there is an interference with penis development after 12 weeks of pregnancy, hypospadias cannot happen as penis formation with urinary opening at tip is complete by 12 weeks of pregnancy. Between 8-12 weeks of pregnancy, the urinary pipe forms under the penis from the base to the tip under influence of testosterone and dihydrotestosterone. Along with the urinary tube the various covering layers of the penis such as spongiosum , bucks, dartos and skin also also formed. Hence when the urethra remain short of tip, all surrounding layers also become short.

Is Hypospadias repair surgery covered by insurance companies or corporates for cashless treatment or re-imbursement?

Hypospadias being a penis birth defect is classified as an external birth defect which can be easily diagnosed as soon as the baby is born. Hence, if parents take an insurance policy after the baby is born, hypospadias surgery treatment costs are not covered by most of the insurance companies in India atleast while in USA, UK it is covered under insurance benefits.

The situation is different for some of the corporate insurance group policy holders. Some big corporates like TCS, Reliance, L & T, Siemens etc issue very employee friendly mediclaim policies which cover all medical and surgical treatments for the employees and their families. Such mediclaim policies cover all pre-existing as well as birth defects for their employees and hence hypospadias repair procedure may be covered by the insurance company by some of these companies.

If insurance does not cover the hypospadias treatment, how much does it cost for Hypspadias repair surgery?

If the insurance company is not covering the treatment, then the parents will have to pay the full charges themselves out of their own pocket. For new parents working in a job or middle class environment this may be financially stressful. What really helps is that Hypospadias repair surgery is a planned procedure. It can be done anytime between 6 months-15 months of age giving parents enough time to rally around and arrange everything from money to other resources. The cost of hypospadias repair surgery depends on the type of hypospadias, complexity of repair, which hospital as well as which type of room one chooses to stay in hospital. On a ball park figure it may wary from 75000 Indian rupees for a minor hypospadias surgery in Hypospadias Foundation to even 3,00,000 Rupees for a complex severe hypospadias surgery in a single deluxe room. Hence, it is best that they meet a hypospadias expert or a pediatric urologist early on in first 3 months of baby’s life and then learn everything about the cost of hypospadias surgery, hospital stay, pre-hypospadias surgery tests and then get mentally prepared for the actual surgery.

About Hypospadias Foundation, Navi Mumbai, India

best hypospadias hospital in india

Hypospadias Foundation is an organisation started by Dr A.K.Singal and Dr Manish Dubey for caring, education and research in field of Hypospadias. Dr Singal is one of the best Hypsoapdias Surgeons in India. The team operates more than 200 children and adults every year with best results in hypospadias treatment. The Foundation operates as a part and parcel of MITR Hospital in Kharghar area of Navi Mumbai. MITR Hospital has cashless and mediclaim tie-ups with all major insurance companies and TPA’s to facilitate cashless treatment of hypospadias if the insurance policy covers it.

If you or your child has hypospadias and need to know more, please write to us at hypospadiasfoundationindia@gmail.com or fill up this contact form

Contact form for Hypospadias Foundation

Watch Videos on Hypospadias Channel by Dr A.K.Singal

Video of Distal penile hypospadias repair surgery

Video of Proximal penile hypospadias surgery

Video of Scrotal hypospadias repair

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Posted in For Parents and Patients,Hypospadias surgeon India,Uncategorized | Posted by Dr. A K Singal | Posted on May 10, 2015 by Dr. A K Singal | Tagged after hypospadias surgery, best hypospadias hospital, flap repair for hypospadias, hypospadias clinic in india, hypospadias surgeon bhopal, hypospadias surgeon in MP, hypospadias surgeon India, hypospadias surgery india, one stage surgery for hypospadias, onlay flap urethroplasty, onlay island flap hypospadias repair, results of hypospadias, results of scrotal hypospadias surgery, scrotal hypospadias, scrotal hypospadias repair, scrotal hypospadias surgery, severe hypospadias, single stage urethroplasty, urethroplasty for scrotal hypospadias

Dressings after hypospadias surgery – everything the parents should know about!

Posted on December 2, 2012 by admin

Why is dressing needed after hypospadias surgery (urethroplasty)?

As after any surgery, a dressing is required after hypospadias repair as well and the reasons for this are many.

  • The dressing helps to prevent infections by creating a physical barrier as well as supports the penis in the healing phase.
  • Penis is an organ which has a tendency to swell up after surgery or any trauma and thus a dressing helps to support the organ in the healing phase after hypospadias surgery.
  • Besides these two major goals, some surgeons use the dressings to prevent bleeding after surgery but with the refined techniques and more experience, bleeding has become less common issue surgery and we at hypospadias foundation generally use a very loose dressing as prevention of bleeding is generally not the goal for the application of dressing.

When we were in surgical training, we had a standard firm elastocrape dressing which used to be applied tightly and was resultantly difficult to remove. The advantage, though, was that it would remain in place without the risk of getting dislodged. On a personal front, as a resident doctor asked to remove those bulky sticky dressings, I was never happy with the dressing as it was difficult to apply, difficult to remove and I felt that it would cause too much of pressure on the healing tissue at the cost of impairing circulation. Also the healing area will not get air to breathe. I was worried that this may result in poor healing as well.

Over the last few years though the primary goals of dressings have remained the same, the dressing after hypospadias surgery itself in our practice has become very easy to apply and remove.

What we use is the following:

At the end of hypospadias surgery, we put a transparent cling wrap kind of dressing called – Tegaderm film- on to the penis – the operated site. This is light in consistency, does not stick to the tissues, is easy to remove and it allows passage of air through it thus aiding in healing.

Over the Tegaderm film, we apply a couple of rolls of thin white gauze just to support the penis and this layer is kept loose and just functions as a soft scaffolding.

A small piece of sticking tape called micropore is applied to hold the gauze piece and the catheter in place and this step finishes the dressing.

In some children, if the dissection has been extensive into the scrotum or the penis length is short we apply a sandwich type of dressing over the whole area instead of a rolled dressing.

Double diaper care- finally the catheter is brought out through a small hole in the inner diaper and left to drain in the outer diaper. Double diapers also help in keeping the area snug and dry during the healing process while allowing the children freedom of movement.

We believe a loose dressing after hypospadias surgery allows good blood circulation to operated area after surgery and thus faster healing. Also, we have observed that the pain is much less with this type of dressing. This dressing is also very easy to remove in the outpatient department during follow up.

What can go wrong with hypospadias dressings?

Dressings can get dislodged fairly frequently after hypospadias surgery. If this happens during first 2-3 days we like to do the dressing again in clinic. But if this happens after 3 days, we just remove the dressing completely and apply antibiotic ointment on the operated area 3-4 times a day and at every diaper change.

When do we remove the dressings

We generally remove the dressings on day 5-6 but in certain distal hypospadias we like to remove the dressings along with the catheter on day 7 after surgery. Removing them together avoids one opd visit for the family.

How are dressings removed after hypospadias surgery/ urethroplasty?

Dressings are removed in the outpatient unit by the junior doctor or the treating surgeon by gently teasing them out. Sometimes normal saline is used to ease out the dressings by making them wet. We have seen that tegaderm based dressings slip out fairly easily in clinic. The only caution to make sure that the catheter is not accidentally pulled up while loosening the dressing.

What happens if there is bleeding into the dressing?

Minor bleeding after hypospadias surgery is fairly common and happens as penis has very robust blood supply. Generally this occurs as a small amount of blood spotting or drops of blood at the tip of penis. If the bleeding stops by itself, nothing needs to be done and this is generally the case. If the bleeding is more in quantity, we ask the parents to visit us and a tighter dressing may need to be applied.

What happens if there is urine leakage into the dressing?

Small amount of urine leakage by the side of the catheter into the dressing is common. If there is lot of urine leakage by the side of the catheter then this means that the catheter may be blocked. The surgeon can then flush the catheter to relieve the block and the leakage will stop.

What happens if there is potty staining of the dressing

Sometimes the children may have loose motions after hypospadias surgery due to side effects of the antibiotics. These may then leak and stain the dressing. In such a case you should wash away the stools and visit the Hypospadias Foundation/ Mitr Hospital to get the dressing changed or removed. If dressing is left potty stained for long, this may allow the bacteria in potty to cause infection in the freshly operated hypospadias.

What care to take after removal of dressing

Child can be given warm tub bath twice a day and an antibiotic ointment should be applied on the operated site 4-5 items per day.  Inner Diapers should be changed at least 2-3 times per day and outer ones as soon as they are full with urine.

 

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Posted in For Parents and Patients,Uncategorized | Posted by admin | Posted on December 2, 2012 by admin | Tagged after hypospadias surgery, best hypospadias hospital, flap repair for hypospadias, hypospadias clinic in india, hypospadias surgeon bhopal, hypospadias surgeon in MP, hypospadias surgeon India, hypospadias surgery india, one stage surgery for hypospadias, onlay flap urethroplasty, onlay island flap hypospadias repair, results of hypospadias, results of scrotal hypospadias surgery, scrotal hypospadias, scrotal hypospadias repair, scrotal hypospadias surgery, severe hypospadias, single stage urethroplasty, urethroplasty for scrotal hypospadias