Chennai to Navi Mumbai: A Doctor’s tale of Hypospadias Repair Surgery for her son

As doctors we are blessed to earn both money and gratitude from our patients. This is even better for us Pediatric urologists as we can experience deep happiness of the parents when their little one gets better after a surgery. We personally feel that we are a part of their life now as we were the lucky one’s to be there when they were struggling to get their little one through a difficult time such as surgery. God has given such unique position to doctors caring for kids as they can then see kids growing up year by year and feel blessed to have invested their life into building up a healthy and safe future.

The diagnosis of hypospadias in a newborn baby can cause a lot of anxiety, distress and pain to the mother who has just delivered, the husband who hasn’t slept in days and the family which has keenly waited for 9 months. At this time in first few days of life, if a proper counseling and guidance can be given by an expert, it can make a world of difference. This may not be possible all of the times as surgeons caring for children with hypospadias on a very dedicated basis are far and few in between across India. Most of the pediatric urologists and surgeons are adept in diagnosing, understanding and counseling for hypospadias and hence should be called in neonatal age itself.

One year back, I received a call from neonatal nursery to see a newborn baby born with hypospadias. Both mom and dad were doctors and worked in Chennai, Tamilnadu, India. Mother was delivering in a Navi Mumbai hospital as the maternal side family lived in Vashi. During the visit, I could see the anxiety and concern writ large on her face. She was torn between playing her role as a mother and her knowledge as a doctor. I discussed with her in detail about the type of hypospadias and also the corrective surgery needed. Since it was a midpenile hypospadias, I told them that a single stage urethroplasty repair was possible. We discussed at length about the right age for surgery and anesthesia. The baby and mother were discharged from nursery at 3 days and then I saw them again at 1 month of age, By this time, the mom was mentally tough and ready for the surgery. We planned the surgery at 6 months of age.

The family travelled from Chennai to Navi Mumbai at 6 months of age with a preplanned date for surgery. Since the urethra was hypoplastic for a short distance proximally and the urethral plate was not very good, we did an onlay island flap repair. The surgery was completed in 2 hours and A.J. was discharged the next morning. The hypospadias dressing was removed on day 5 and the urinary catheter was removed on day 10 after surgery. A.J. healed well over next 2 weeks and the family visited me again 6 months after surgery. A.J. is passing urine from tip of penis, the penis is straight and there is an excellent cosmetic result of his hypospadias surgery. The family is overjoyed and I am also relieved and happy with the good outcome.

The mother sent us a nice thank you note last week and it made my day. It follows verbatim here:

Hello Dr. Arbinder Singal,
A happy parent with a blessed son.
First I would like to convey my heartily thankfulness for your key role in my life. I would rather tell it as my life because my son is my life.
October 2012, good news was accompanied with sad news too, when my pediatrician told me that my son is suffering from hypospadias. Even though I am also a doctor, a fearful alarm rang inside a mother with loads and loads of questions.
But to my rescue doctor, your opinion was asked. During your visit, you were polite and calmly answered all my questions and relieved my fears.
As I am from Chennai and my parents stay in Chennai, everything fell in place very conveniently.
After 6 months, the day for hypospadias surgery came, as doctors, my husband and I were ready mentally but emotionally it was a nightmare.
But thank you doctor, MITR doctors and staffs- All made us feel very comfortable. You were so supportive and took care of everything right from the beginning.

That day gave a new life to my son. Now he is doing fine and leading a happy and normal life.

Six months have passed and everything is well.

Thank you God
Thank you doctor
Thank you MITR Hospital and staff
Thank you Hypospadias foundation
May your sincere service continue forever for the needy.
God bless you
Yours
A happy parent with a blessed son

Footnote:

These are the letters and emails which make caring for kids worthwhile even in the face of all risks and uncertainties of surgery on a small child. In the dark times, these blessings shine like rays of hope and give energy to carry on. I wish to express gratitude to all parents who have trusted us with the care of their little ones. We feel truly blessed and honoured to be of help.

About the author:

Dr A.K.Singal is a Pediatric Urologist and a specialist hypospadias surgeon. He does more than 200 hypospadias repair surgeries every year and has the best results for complicated and failed hypospadias. Every year he gets referred complex, severe and failed hypospadias patients from all over India and more than 20 countries. Along with the team at Hypospadias Foundation and MITR Hospitals, he feels joy and blessings in caring for children with hypospadias.

You can send us an enquiry by filling up this form: http://hypospadiasfoundation.com/contact-patient.htm

Or you can send us an email at hypospadiasfoundationindia@gmail.com

Or you can call Dr Rajkumar, Coordinator of Hypospadias Foundation, at +91-9821261448 between 10am-4pm

Also, you can call up Dr Rajkumar, Dr Singal’s assistant and Coordinator of Hypospadias Foundation on +91-9821261448

Videos of Hypospadias Repair surgery by Dr A.K.Singal

Boy from Congo (Africa) finds cure for Distal Penile Hypospadias in Navi Mumbai, India- Successful hypospadias repair surgery even after circumcision

Hypospadias is the most common urological anomaly (birth defect) seen in newborn babies worldwide. It is mostly diagnosed soon after the baby is born when the opening of for urine is seen to be on underside of penis, the foreskin (prepuce) is incomplete on the underside and there may be a bend in the penis (chordee). Very rarely, if the hypospadias is very mild, it can be missed on neonatal examination by even a pediatrician.

Lot of countries and religions practice and advocate newborn circumcision in all male babies but whenever hypospadias is diagnosed in newborn age, circumcision should not be done. During circumcision, the prepuce is cut off and a very vital tissue which is required for hypospadias repair surgery is lost. Prepuce or its layers are used for anatomical hypospadias correction surgery. In a circumcised boy, hypospadias repair becomes difficult and complication rate of hypospadias surgery is little higher.

Master K.Hadriel.Ileunga was born in Congo (Africa) in a small city. His doctor did not recognize at birth that he had a distal penile hypospadias. He underwent a circumcision in the first few days of life by a general practitioner doctor. Later his parents and doctors realized that Hadriel had a distal penile hypospadias. As he grew up in Congo (Africa) his parents worried about his hypospadias. They visited a few doctors in Congo but there was no pediatric urologist available in Congo who could do a hypospadias repair after circumcision. At this time, they learnt about Hypospadias Foundation in Navi Mumbai, India and sent an email to come and get treated under Dr A.K.Singal’s care, one of the most renowned pediatric urologists and the best Hypospadias Surgeon in India.

Finally in first week of Jan 2015, the family met Dr Singal in Navi Mumbai. On examination, Hadriel had a distal penile hypospadias without chordee. There was no prepuce as he had undergone a circumcision in newborn age. After discussing with the parents, Hadriel was taken up for Hypospadias repair surgery on 16 Jan 2015. The surgery was done using Tubularised incised plate urethroplasty – also called Snodgrass urethroplasty. The whole urethroplasty was completed in one stage. The child was discharged from hospital the next day and the hypospadias dressing was removed after 5 days. The urethral catheter was removed after one week of surgery. Hadriel passed urine in very good stream without any difficulty. After a final follow-up two week after surgery, Hadriel has gone back to Africa- his country Congo and family is very happy. Fortunately, he had an excellent result of hypospadias repair surgery even after a neonatal circumcision.

Dr A.K.Singal with Hadriel, hypospadias patient from Congo

Dr A.K.Singal with Hadriel, hypospadias patient from Congo

Watch Video of Single stage surgery for severe scrotal hypospadias by Dr A.K.Singal, Hypospadias specialist surgeon

Contact Form for Hypospadias Foundation

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    Family travels from England (UK) for Hypospadias repair surgery of their child to Navi Mumbai, India

    Hypospadias remains one of the most common urological anomalies across the globe affecting almost 1/150 newborn boys. No nation or economic status or religion is exempt from its occurrence. The art and science of hypospadias treatment has evolved significantly in the last two years with a single stage repair of hypospadias a real possibility in most of the cases. The results of hypospadias surgery are of course better at centres where there are specialist hypospadias surgeons doing dedicated hypospadias treatment in large numbers every year. Even the complications of hypospadias surgeries decrease significantly with increasing experience. This was the aim with which we started Hypospadias Foundation in 2008. Now 6 years later, we are happy to provide excellent outcomes and give happiness to kids and families who travel to India from all over the world.

    The Child from Great Britain

    Master Narain was noted to have hypospadias as soon as he was born in England. The pediatrician advised the family to meet the pediatric surgeon or pediatric urologist when the child was three months old. Through the NHS system, the family went and met a Pediatric Surgeon who advised hypospadias repair surgery after 1.5-2 years of age.

    Mother and father, both UK residents, were worried about delaying the surgery so much as somehow they felt that once the surgery is needed they better get it done at a younger age than a later age. They just couldn’t understand the point of waiting for the surgery which would anyway be required. With this dilemma about the age for hypospadias surgery, they contacted us at Hypospadias Foundation. After a few tele and online consultations they decided to travel to India for Hypospadias repair surgery with us at MITR Hospital in Navi Mumbai, India. We advised surgery between 6 months to one year of age. Finally, when Narain was 9 months old they traveled to India from England and visited us.

    On examination, Narain had a distal penile hypospadias without any chordee. The urethral plate was pink and healthy and he seemed suitable for a single stage Hypospadias repair. Parents did not have too many questions and I was very surprised. When I asked, they said that they have read a lot of blogs written by me on hypospadias treatment and were upto date with what their son is going to go through. This was a very happy consultation indeed. Saved me time and energy but still I went through the pre and post hypospadias surgery routine with them explaining to them. They just nodded their heads and posted Narain for surgery one day later and meanwhile we got the blood/ urine tests and pre surgery fitness for anesthesia.

    Surgery was done as first case in the morning the following day. Surgery was done under caudal analgesia and sevoflurane anesthesia. Since the urethral plate was good and the hypospadias was not very severe (distal penile hypospadias), we did a Tubularised incised plate urethroplasty also called Snodgrass repair urethroplasty. The surgery took only 75 minutes. Narain tolerated the procedure well and was to his usual playful self in a few hours after surgery. We sent him home by the next morning on usual oral medications for pain and bladder spasms and a mild antibiotic. One week later, the family visited us again in the outpatient clinic for removal of dressing and catheter. Narain passed urine well without any issues and had a good healing operative site at the time of hypospadias dressing removal. Another followup was scheduled at 10 days after catheter & dressing removal. Narain was passing urine in a good straight stream without any difficulty. Also the cosmetic result was excellent. The family was overjoyed and was able to travel back to England within three weeks of surgery. We requested the family to send us a short video of Narain passing urine and a few pictures of his penis at about 6 weeks and 3 months after surgery to confirm that everything has healed without any complication. We received these videos and pictures a week back and were happy to note that there was no complication of the surgery. We expect Narain to do very well and live a normal life after the hypospadias surgery.

    About the author:

    Dr A.K.Singal is a renowned Pediatric urologist and is considered one of the best hypospadias surgeons in India. He treats more than 100 kids with hypospadias every year at various hospitals in Navi Mumbai, Thane and Mumbai. Lot of kids travel from neighbouring cities such as Pune, Ahmedabad, Surat, Goa and as far as Bangalore, Hyderabad, Calcutta, Delhi, Jaipur, Chennai etc.

    He can be contacted by filling up the form here: Contact form Dr A.K.Singal

    Dr A.K.Singal during Hypospadias surgery

    Watch Video of Distal Penile Hypospadias Repair Surgery by Dr A.K.Singal, expert hypospadias surgeon

    Watch Video of Single stage surgery for severe scrotal hypospadias by Dr A.K.Singal, Hypospadias specialist surgeon

    Contact Form for Hypospadias Foundation

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      Letter from Afghanistan: 8 month old child undergoes successful hypospadias repair surgery at Hypospadias Foundation in Navi Mumbai, India

      Hello Dr A.K.Singal,

      My feedback from my baby’s operation at Hypospadias Foundation & MITR hospital in Navi Mumbai, Kharghar, sector 21:

      When I was told by  my baby’s doctor at the time of birth that he had hypospadias, we were very worried about it as it was the first time I had heard such case. Then I started searching about treatment and could not find any specialist locally in Afghanistan. Then we searched for a hypospadias specialist in India and could find the best pediatric urologist surgeon in Mumbai called Dr. A. K Singal in MITR hospital in Navi Mumbai although, I searched in Delhi and other states. Indeed what all I found it was just from Google net and I was really not sure what is going to be happen. Many questions arose into my mind that how the operation is going to be done? How many days my son would be admitted? And many other questions were there.

      Eventually, I got appointment with the MITR hospital via email with Mrs. Emily Paul who was very helpful and then we decided to go India for the treatment and finally reached the mentioned hospital on the 1st December, 2014. In the same day, Dr. A. K Singal visited my child and he impressed me when he talked about the operation and we decided to operate him after two days. Then on the 3rd December my baby’s operation was done.
      The operation was done in a very professional way and successfully with no issue. Then I realized that I took a really right decision and found the right hypospadias doctor. It was amazing that in the same day my baby did not have any pain and discharged from the hospital but I requested to remain for some more days for betterment of the child. 

      We (me and my wife) have very good memories from the Hypospadias Foundation and MITR Hospital especially from Dr A.K.Singal and now we know why he is a renowned Pediatric urologist and one of the best Hypospadias surgeons in India. The staff of Hypospadias Foundation based in MITR Hospital is good and the nurses were really outstanding. I thank them too.

      My little angel is doing very well after surgery with no issue and we overcome those all tensions and worries which we had in the past. I really appreciate Dr. A. K Singal and whole MITR team with professional communication and cooperation and your friendly environment.

      Considering that our son had hypospadias which can have lot of stigma, we request you to keep his name and identity confidential. We would be happy to interact with parents whose children are suffering from hypospadias any time offline.

      Thank you Dr. Singal.

      Best Regards,

      Mr M.H., Herat, Afghanistan

      Case description:

      Master F.H.,8 months old child underwent distal penile Hypospadias treatment at our hospital recently (Dec 2014). Father had written to us about a month back expressing a desire to travel for Afghanistan to India for the hypospadias repair surgery. They had sent us pictures of the penis via email and we could explain to them the type of anomaly and the surgery needed for the same. Fortunately, the father took very good and clear pictures as instructed and it was easy for us to understand even without examining the child. Ms Emily Paul and Dr Rajkumar coordinated the OPD appointments and then one fine day the baby was at our hospital in Navi Mumbai. We confirmed the hypospadias to be distal penile hypospadias and did the pre surgery checkup and fitness by a Pediatrician. We took up the baby for surgery on 03/12/2014 and surgery was done using Tubularised Incised plate urethroplasty (TIP repair) also called Snodgrass repair or Snodgrass urethroplasty. Originally described by Dr Warren Snodgrass, the TIP repair is one of the most reliable and common repairs done worldwide for distal and midpenile hypospadias in selected and suitable cases.

      The surgery was finished in one hour and F.H. was allowed feeds after 3 hours of surgery. He was at his playful best by evening and we planned to discharge the baby. Parents were very worried about taking him to a hotel and requested to stay in the hospital for another week till the dressing and the catheter were taken out. In normal circumstances, we discharge most of the hypospadias surgery kids by evening of surgery but here understanding the situation we allowed them to stay for a week. Finally the catheter and the dressing were removed in 5 days and the parents took the child to Pune with them. I saw them on 15th Dec 2014 once again before their final flight back home to Afghanistan from Delhi. He was doing very well and the penis had healed very nice with good cosmetic and functional outcome.

      Staff and nurses were very fond of master F.H. as he was a very happy baby and used to come to everyone’s arms easily and used to play with them. He used to be in my lap all the time. All of us here at MITR Hospital and Hypospadias Foundation wish him the very best in life. And we all miss him.

      About the Hypospadias Foundation & Dr A.K.Singal

      Hypospadias Foundation in Navi Mumbai, India is the world’s only organisation committed and dedicated to treatment and care of children having hypospadias. Over last 6 years children from all over India and from more than 15 countries have benefitted from care at Hypospadias Foundation.

      Dr A.K.Singal, Pediatric Urologist and Hypospadias Surgeon is an expert and renowned surgeon for management of children and adults with Hypospadias. Dr Singal and Dr Manish Dubey are close friends and together started Hypospadias Foundation in Nov 2008.

      Dr A.K.Singal during Hypospadias surgery

      Dr Singal can be contacted by filling up this form: Enquiry form for Hypospadias

      Or you can call up Dr Rajkumar (Dr Singal’s assistant) at +919821261448

      His clinic timings in Navi Mumbai, Thane and Mumbai are available here:

      Clinics and Timings for Dr Singal

      Hypospadias repair surgery videos by Dr A.K.Singal:

      Contact Form for Hypospadias Foundation

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