best hypospadias surgeon Archives - Page 3 of 6

July 07 2015

Single stage hypospadias repair surgery video for a child with failed hypospadias: Nagpur to Vellore to Navi Mumbai, India

Like every other surgery, hypospadias correction surgery has its own risks, complications and failures. Inspite of the best intentions and efforts of the parents and the treating hypospadias surgeon, still the results may be sub-optimal after the first surgery. Though at the end of hypospadias surgery in OT it may seem that the surgery has gone very well, sometimes there may be minor complications which necessitate a second surgery for hypospadias in some children. The rate of second surgery for a complication or failure of first hypospadias surgery decrease with the expertise and experience of the hypospadias surgeon but it is never zero and that is an important thing for the parents and families to understand.

When the first surgery for hypospadias fails, parents get very disturbed and start looking for more information on why it happened and the solutions and second opinion for hypospadias to help fix the problem. Most of the times, the primary surgeon may be the best person to solve the problem but sometimes the complication may be severe and in such cases the patient should be referred to a centre of excellence in hypospadias surgery.

While minor problems like fistula or cosmetic issues can be treated easily with as second minor surgery- major complications of hypospadias surgery such as urethral breakdown, dehiscence, urethral diverticulum or stricture may require more complicated or even a staged repair with grafts. Hence, the dictum- that first surgery for hypospadias is the best surgery- further surgery if the first one fails is always more difficult and challenging.

At Hypospadias Foundation, we regularly receive kids and adults from all over India and other countries who have had a failed hypospadias surgery elsewhere. Families request for a second opinion for the hypospadias treatment and we advise them comprehensively. Some of these cases really benefit from the specialist care offered by a dedicated hypospadias team.

Case Story

Master A.G., a 3 years old boy, resident of Nagpur, underwent a surgery for a proximal penile hypospadias surgery at a hospital in Vellore. Unfortunately, the healing was not optimal and the whole repair had a breakdown. After 6 months of previous surgery, the family wrote to us and visited us at our centre in Kharghar, Navi Mumbai. On examination, the child has proximal penile meatus with mild chordee. There was a remnant of foreskin (prepuce) on the underside of penis. There was no foreskin left on the topside of penis. We explained to the parents that this may require a two stage repair but we will try out best to make a flap from the residual foreskin and do the surgery in one stage.

Finally after pre-surgery tests and fitness assessments, we took the child for redo-hypospadias surgery. We could make a nice onlay flap out of the foreskin remnant by carefully dissecting the blood supply and preserving the supply to this flap skin. The flap was used to make the new urethra in one stage as it can be seen in the video below. The surgery took about 3 hours and the child was allowed feeds four hours after surgery. The dressing was removed after 7 days and catheter after 10 days. The hypospadias site healed very well and the child was examined again after 1 month. He was passing urine well in a single stream from the tip of penis. Now, 6 months after hypospadias repair, A.G. continues to do well and his parents are very happy and we are also overjoyed to achieve a good result in this challenging failed hypospadias case. The detailed hypospadias surgery video can be watched by clicking below. Besides the story mentioned here, the video below shows another child story from Raipur, Chattisgarh where the first surgery resulted in a penile torsion and a large fistula. The child underwent a successful single stage surgery at Hypospadias Foundation:

Watch Video of Failed Hypospadias surgery by Dr A.K.Singal

If you or your loved one has hypospadias and wish to seek an opinion, please write to us at hypospadiasfoundationindia@gmail.com or contact Dr Rajkumar- Coordinator at +91-9821261448 between 10 am-5pm India Time.

You can also fill up this contact form: Contact Hypospadias Foundation

or come to MITR Hospital in person after taking an appointment by sending an email at frontdesk@mitrhospital.com or calling up at +91-22-27743558/ 4229 or +91-9324180553

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

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

Watch video of Distal penile hypospadias repair by Dr A.K.Singal

July 07 2015

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

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.

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

June 06 2015

Letter from Australia makes our day and life worthwhile: Infant with scrotal hypospadias gets operated successfully in one stage in India

Hypospadias is a common urological anomaly and fortunately most of the hypospadias are distal or midpenile in variety with good results in one stage surgery. Scrotal hypospadias are the most severe forms of hypospadias where the opening in far behind in scrotum, in between the testicles. 6 months back we treated a child with hypospadias who travelled with his family all the way from Australia for a hypospadias repair surgery. But the story actually started as soon as the baby was born. The family had contacted us for an email and telephonic consultation and we were there with them from the neonatal age till the surgery and the care continues electronically even now.

Fortunately, with meticulous pre-surgery planning and good support we could get a good result of the surgery in one stage itself. The child is doing very well now and doesn’t look like that he will need any further hypospadias surgery. The family was overjoyed and they have sent us an email now (6 months after surgery) and we were all very happy to read the email. It made our day and also made the whole purpose of starting Hypospadias Foundation worthwhile.

We have taken the liberty of using most of the email in an unedited format here after seeking due permission from the family.

Hi Dr. Arbinder Singal,

How are you?

Please find below what we truly felt. Also as discussed, we would not prefer either our or or son’s name to be reflected in the recommendation, however please feel free to provide my details to parents who are in a similar situation and need help just like we did when our son was diagnosed with severe hypospadias.

First News

It all started on 2^nd December when my son was born in Sydney (Australia), it was the happiest moment of my life but I didn’t know that it will last only for the next 24 hours.

The next morning, as a usual process in Australian Hospitals, Specialists came to check my son and called me. The specialist checked my son and without any emotions or sympathy or even empathy told me that my son is suffering from Hypospadias and that too a severe one and it will take at least 2-3 operations period. My ears were striving hard to hear that after those operations it will be completely cured and everything will be fine but the doctor told me that the Hypospadias is severe and there is no guarantee and gave me an information booklet with scary after operation images. As far as I remember I asked him thrice may be more that whether my son would be alright after those operations? yearning for an answer that “everything will be alright” may be a pat on my shoulder to give me some strength or courage to deal with the situation but he left without saying even a single positive word.

I could barely walk after that conversation, everything around was meaningless and sad. My wife was still in the hospital recovering from the caesarean operation, I chose not to tell anyone in my family and let them be happy. I came home that night as you are not allowed to stay in the hospital in Australia. I was not able to sleep that night and the next morning while I was still at home, all my emotions came out, I couldn’t stop the tears and my family came to know about it and tried to give suggestions but that doctor had filled my whole system with so much negativity that I believed that there is no solution and my son will never be cured. After venting out my emotions, I started researching about Hypospadias specialists in the world and I found Dr V.R.Jayanthi and called his clinic in U.S.A but he was not available. I did some more research and found Hypospadias foundation in Navi Mumbai, India. Honestly I didn’t care to read the content on the site and went directly to the contact us page as I was so desperate to talk to a specialist and got through Dr. A.K. Singal’s clinic and fortunately they helped me to set up an telephonic appointment with him.

Half an hour Conversation changed everything!

Carrying a huge backlog of negativity, I called up Dr. Arbinder Singal. The conversation started with a lot of questions and Dr. Arbinder Singal listened to all my questions and concerns patiently and irrespective how silly the questions were, he answered to every question in detail. Honestly that conversation changed my life and in particularly one sentence from him – “THERE IS NO HYPOSPADIAS WHICH CANNOT BE CURED”. He guided me to contact a pediatric endocrinologist right away and explained in detail on how to proceed with the next steps. I recorded that conversation and told my wife about the news because now I had the solution – Dr. Arbinder Singal!

A Close shave

I am really thankful to Dr. Arbinder Singal for recommending a pediatric endocrinologist at that point. I want to again emphasize here that everyone apart from Dr. Arbinder Singal missed an important step in the journey – Meeting a Pediatric Endocrinologist.

As per the paediatric endocrinologist – Dr. Andrew Biggin (he is still my son’s paediatrician and has agreed to mention his name) there were some injections which needed to be given to my son before a certain age which we would have definitely missed as no other Doctor asked us to meet a paediatric endocrinologist. We communicated a lot with Dr. Arbinder Singal updating him about the progress and again asking questions to which he patiently responded every time. He also helped us to get in touch with the other parents whose children had undergone hypospadias repair surgery under his care which helped a lot as they explained us how they went through the treatment and journey. We are really thankful to those parents as well as every time we had an emotional breakdown or we felt nervous they acted as a big emotional support and had long conversations calming us down. Finally Dr. Arbinder Singal helped us decide a date and hospital for hypospadias operation.

The Surgery..

We travelled to India for surgery and we arranged a villa near Fortis Hospital in Vashi, Navi Mumbai and went to meet Dr. Arbinder Singal for the first time in Mumbai. After our meeting the comfort level and confidence increased multi-fold, he was very nice to speak with and inculcated the same confidence in us. He checked my son and said he will try to do it in one operation itself. We had already booked a room in Fortis and admitted my son for the surgery. We met him again before the hypospadias operation, we were nervous but we were calm as we knew that our son was in safe hands. All the hospital staff was very helpful on the operation day and Dr. Arbinder Singal gave us the good news that the operation is successful and my son would not need another surgery.

Highly Highly Recommended!

I would highly recommend Dr. Arbinder Singal as he is an hypospadias expert and good human being. He is reachable and understands the emotions & nervousness which the parents go through. All the more the issue which all the doctors in Australia could solve only by doing multiple hypospadias surgeries, he did that in one go with a single stage hypospadias repair.

I and my family are and would be really thankful to him for forever.

Thanks Dr. Arbinder Singal & Hypospadias Foundation!!

Regards,

A happy kid and his family

Sydney, Australia

About Hypospadias Foundation and Dr A.K.Singal

Hypospadias Foundation is an organisation dedicated to care & cure for patients children and adults suffering from Hypospadias and DSD (disorders of sex development). It is located within a boutique Urology centre – MITR Hospital in Kharghar, Navi Mumbai, India (www.mitrhospital.com ). Hypospadias Foundation was started in 2009 by Dr A.K.Singal and Dr Manish Dubey and till date more than 800 children and adults have been treated at the Foundation from all over India and more than 20 countries (june 2015). The foundation keeps on growing with blessings from families and support from society.

Dr A.K.Singal is a renowned pediatric urologist surgeon and a top hypospadias specialist practicing in Mumbai, India. He is an expert in management of children and adults with hypospadias and is a strong force behind community and medical education for hypospadias. Every year he does more than 200 surgeries for hypospadias and conducts research for hypospadias. For his deep passion and excellent results in hypospadias, Dr Singal is counted as one of the best hypospadias surgeon’s in the world.

Hypospadias Foundation can be reached at hypospadiasfoundationindia@gmail.com or you can call Dr Rajkumar (Coordinator) at +919821261448

Or you can fill up this contact form: Contact Hypospadias Foundation

Watch Video of Scrotal Hypospadias Surgery by Dr A.K.Singal

Watch video of proximal penile hypospadias repair surgery by Dr A.K.Singal

Watch video of distal penile hypospadias operation surgery by Dr A.K.Singal

April 04 2015

Long journey from Patna to Navi Mumbai: Severe scrotal hypospadias managed successfully at Hypospadias Foundation

Hypospadias is one of the most common urological anomalies in boys. While 80% of all hypospadias are mild and of distal or midpenile, 20% are proximal hypospadias. Severe varieties like scrotal hypospadias form only 5% of total burden of hypospadias. Severe hypospadias such as scrotal hypospadias often have associated chordee (bent penis) and this may be very severe too posing a challenge for the hypospadias surgeon. We have realized in last few years that making the penis straight (chordee correction) is THE MOST IMPORTANT step of hypospadias repair procedure. While most of the severe scrotal hypospadias are also repaired in a single stage (almost 90% are suitable for a single stage urethroplasty), in 10% of the children the anomaly is so severe especially due to severe chordee that two stage repair may be better for an optimal long term outcome.

Master R.P. was born with scrotal hypospadias, severe chordee in Patna, Bihar and was advised to undergo surgery after 1 year of age. The parents went to multiple doctors in Patna, Delhi and finally came to consult Dr A.K.Singal, renowned Hypospadias surgeon at MITR Hospital, Navi Mumbai. On examination, the child had a severe scrotal hypospadias, severe chordee (almost 90 degrees) and abnormally fused skin of scrotum to the penis. This almost looked like a trapped hypospadias penis due to skin shortage. Dr Singal discussed in detail with parents that such a severe hypospadias may require hypospadias treatment in stages. Due to the severity it may be impossible to correct all the defects in one surgery. Also the penis length may have got shortened and cosmetic result would also been suboptimal.

Finally, R.P. was taken under anesthesia and hypospadias repair surgery was started. As a first step the penis was degloved. Urethral plate was divided and the fibrous bands causing chordee on the underside of penis were divided deeply till the scrotum. The penis was almost straight after this maneuver with just 30 degree bend which was further corrected by a placing a placating stitch on the top side of penis (tunica albuginea plication or TAP). Artificial erection test confirmed the complete correction of chordee. Since the chordee was severe and the urethral plate was also divided, single stage surgery would have carried very high failure rates. Hence, a staged urethroplasty was planned. The skin on the top of the penis was divided in midline and brought to the underside of penis. A part of the skin was advanced into the head of penis (glans) so that the new urethra in next stage would be constructed till the tip of penis. This is called Thiersch Byar’s urethroplasty stage-1. There was a compression dressing done which was removed after 7 days and the family travelled back to Patna after a total of 14 days after first hypospadias surgery.

Happy family with Dr Singal after Surgery

The family sent us some pictures in the healing phase over next few months and the second stage urethroplasty was planned after 6 months of first hypospadias surgery. When we saw the patient again – the flaps and the skin on the underside was very well healed and ready for second stage. Second stage urethroplasty was done and it took just 2 hours for the surgery. The catheter was removed after ten days and the R.P. passed urine in a good stream from the tip of the penis like a normal boy. Family was delighted and after another follow-up visit one week later they travelled back to Bihar.

According to Dr Singal, “With the experience and expertise, currently we do single stage surgery for even scrotal hypospadias and other complex hypospadias. The only limiting factor is the severity of the chordee. Sometimes in sever chordee we need to apply a cut on the underside of penis to straighten it. In such cases, it is better to do a staged repair. In our experience, two stage hypospadias surgery can have excellent cosmetic and functional results. It also provided a longer penis length by straightening the penis and elongating the underside of penis when chordee correction is done.

About the author:

Dr A.K.Singal is a senior Pediatric Urologist and a renowned Hypospadias expert surgeon in Navi Mumbai, India. Every year he operates more than 200 kids and adults with hypospadias from all over the world and from all over India. Dr Singal has done lot of clinical research and conducted training programs for hypospadias surgery in India. Due to expertise in managing complex cases of severe hypospadias and failed hypospadias operated elsewhere, he is counted as one of the best and top hypospadias surgeons in India.

Dr A.K.Singal delivering his talk at ESPU

About Hypospadias Foundation:

Hypospadias Foundation is World’s first and only organisation dedicated to care and cure of children and adults with hypospadias. Started in 2008 by Dr Singal and Dr Dubey, more than 1000 patients have benefitted from care at the foundation from more than 20 countries. The blessings and goodwill only continues to grow from a single point focus of excellence in hypospadiology. The foundation soon intends to start formal training courses in Hypospadias surgery for international doctors.

To contact us you can

Email us at hypospadiasfoundationindia@gmailcom

Or Call Dr Rajkumar, Coordinator, at +91-9821261448 between 10am-4pm.

Else you can fill up this form: Contact Hypospadias Foundation

Watch video of Scrotal hypospadias surgery repair by Dr Singal

Watch video of Proximal penile hypospadias surgery by Dr Singal

Contact Form for Hypospadias Foundation

Please fill all clinical details and upload pictures and clinical summaries (if available)

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