Hypospadias repair surgery & treatment in adults

Hypospadias is the most common urological birth defect occurring in upto 1/150 newborn boys, which measures upto almost 100,000 (1 Lakh) new cases every year. While most of the cases are not hereditary or genetic, 6-8% of hypospadias cases have a family history of hypospadias or associated genetic disorders. In the current era and in cities, most of these children are referred to pediatric urologists or surgeons in early childhood and receive timely treatment for hypospadias. This was not true 20 years back or even now in many parts of the world. Hence, there are a large number of adults living with hypospadias across the world either unrepaired or some who have failed hypospadias surgery in childhood. In India alone, there are an estimated 5 lakh adults who have either not received hypospadias surgery or have failed hypospadias surgery in their earlier years and their families or they themselves have given up.

Every year, we receive adults from many countries in South East Asia and rest of the world who travel to India to Hypospadias Foundation to find treatment for their Hypospadias problem. But every adult undergoing hypospadias treatment understand a few facts which make hypospadias surgery and post-surgery course a little different to that of children.

Hypospadias repair surgery in adults- Differences from surgery in children:

  1. Longer healing time than children: Tin expert hands, overall success rates of hypospadias treatment and surgery in adults remain good and comparable to hypospadias repair in children, the healing of penis takes longer. Though one can start passing urine normally in 2-3 weeks, it may take upto 2-3 months for the penis skin to heal fully.
  2. Longer time for indwelling urine catheter: We like to keep catheter inside for 10-14 days for distal hypospadias repair in adults and 14-21 days for severe hypospadias repair in adults. This is in contrast to children where most of the catheters are removed in 5-10 days.
  3. Higher risk of infections: Since there is hair growth in penile area and more sweating in adults, the chances of skin infections at hypospadias surgery site is higher in adults.
  4. Pain after surgery: As adults have night time erections during a certain phase of the sleep, there may be episodes of severe pain during healing phase in first one month. Hence we give medicines to decrease the frequency of erections for 4-6 weeks and stronger pain killers in adults.
  5. Abstinence from sex: We advise abstinence from sex and masturbation for almost 3 months after hypospadias surgery in adults.
  6. Off from work: Since most of the adults are in a job or business, it is important to take atleast 4 weeks off from work before planning hypospadias surgery.
  7. Uroflowmetery: We recommend performing a test called uroflowmetry to check the speed of urine passage at 3 months and one year of surgery to make sure that the new passage is of good caliber.

Though there are challenges in treating adults with hypospadias, but with diligence and dedication very good results can be achieved at centres of excellence in Hypospadias treatment. A good counselling, a thorough OPD consultation are a must before embarking on the surgery to ensure that the adults with hypospadias understand the treatment, results and long term outcomes. This also helps in setting the expectations right after Hypospadias surgery.

About Hypospadias Foundation

Hypospadias foundation is the World’s first and only organisation dedicated to care of children and adults suffering from Hypospadias. Founded by Dr A.K.Singal and Dr Manish Dubey in Nov 2008, more than 700 children and adults have found hope and cure at Navi Mumbai India. Kids and adults travel from all over India and now more than 20 countries to Navi Mumbai for state of art treatment, surgery for hypospadias and best results. The unique teamwork between a pediatric and adult urologist allows adults with hypospadias to gain the best results in treatment of hypospadias.

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