Mr N.S. was born with distal penile hypospadias in Nepal. Due to lack of knowledge and since there were no pediatric urology/ hypospadias specialists in Nepal, his parents did not get his hypospadias surgery treatment in childhood. N.S. contacted us at Hypospadias Foundation at Navi Mumbai and sent his medical records by email along with some pictures. After an electronic second opinion, he finally travelled to Navi Mumbai, India in September 2014.
On examination, N.S. had a primary distal hypospadias with mild chordee. We planned to do a single stage TIP repair (Tubularised Incised plate urethroplasty or Snodgrass repair). At first, we degloved the penis and checked chordee. He had mild chordee which was corrected by 12 O’clock tunica albuginea plication. Glans wings were raised and the new urinary tube (urethra) was made over 12 Fr silicon catheter. To give additional security to the repair, we covered the urethroplasty with dartos flap for secure healing and to prevent urethral fistula. Finally, excess foreskin on top was excised giving a circumcised look to the penis. N.S. was discharged the day after surgery on antibiotics, analgesics (painkillers), antacids and antispasmodics. Additionally, a medicine was given to decrease erections temporarily.
Adult with primary distal hypospadias
After degloving note mild chordee, corrected by plication
Midline TIP incision, glans wings raised. Note Dartos flap
One week later, we removed the dressing in clinic and finally the catheter was removed on day 14. N.S. had some pain initially on passing urine but within 2-3 days he was passing urine normally from the tip of penis. At 5 years, follow up in 2019, he had healed very well and was passing urine normally and was extremely happy with the result of hypospadias repair surgery. He had a marriage and is living happily with his wife and kid in Nepal.
Urethroplasty first layer is completed, dartos flap in place
Completed Adult Hypospadias repair
3 months later- Good urine stream from the tip
Hypospadias repair surgery in adults
There are many adults living with unrepaired hypospadias or failed hypospadias surgery in childhood across the world. In India alone, there are an estimated 5 lakh adults who have either not received hypospadias surgery or have failed hypospadias surgery in their childhood years. 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.
Though there are challenges in treating adults with hypospadias, but with diligence and dedication particularly good results can be achieved at centers 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 one of the best hospitals centre in India and the world for surgery treatment for hypospadias in adults and children. Every year, we treat more than 200 kids and adults with primary and failed hypospadias at Hypospadias foundation in Navi Mumbai, India and at Ibn Al Nafees Hospital in Bahrain. With the teamwork and years of experience in treating children and adults with primary and failed hypospadias, at Hypospadias Foundation we can give them cure and their normal life back.
Dr A.K.Singal is an expert and top hypospadias surgeons at Hypospadias Foundation in India. Besides surgeries in India, he also travels to Ibn al Nafees Hospital in Bahrain for performing hypospadias surgeries in children and adults from Gulf, Middle East and African countries.
If you wish to contact him, pls fill up this form- Contact form for Dr Singal
or pls call up his clinic for an appointment- Clinic details for Dr Singal.