# Hypospadias Surgery in July



## 2lil'monkeys (Feb 18, 2008)

Hello. My intact son will be having surgery in July for hypospadias and chordee repair. If you've been through this, can you give me any advice on what questions I should ask in our pre-operative meeting with the surgeon? We're meeting with her for the second time in June. Also, if you have any reasurrances you can share, I'd really appreciate it. Oh, my son is turning one in July. He still nurses frequently and co-sleeps most of the night with us, so maybe that will help with his recovery? TIA.


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## perspective (Nov 3, 2007)

Quote:


Originally Posted by *2lil'monkeys* 
Hello. My intact son will be having surgery in July for hypospadias and chordee repair. If you've been through this, can you give me any advice on what questions I should ask in our pre-operative meeting with the surgeon? We're meeting with her for the second time in June. Also, if you have any reasurrances you can share, I'd really appreciate it. Oh, my son is turning one in July. He still nurses frequently and co-sleeps most of the night with us, so maybe that will help with his recovery? TIA.

Well I had the surgery myself when I was born. To this day, I cant really say for sure if I would have done the same thing or not as my parents decided if I was in control. I know your asking for reassurance, but I dont think thats what you need, and I dont really know doing so would be very honest.

I have heard of a few guys who had this done, and when they never had the slightest idea it happened until a parent told them years down the line. But I also know many guys who were always aware they were different, and knew something had been done with them. (I found this to be the more common thinking)

In reality, the surgery could go great, or it could go badly. Beyond scarring, fistuals can develop, and even though they can be repaired, with a certain percentage of boys, no matter how many times they fix a fistula, it will open up again, and each operation to close them, leaves more scar tissue.

Because of this, deciding to do this surgery should be based on how severe the situation is. For example, if the urethra opening is still on the head, I high suggest NOT having surgery, and letting him decide what he wants to do later. The farther down the opening is, the more I would suggest having the operation.

Yet the intersexual community (many of whom have had similar surgery themselves) highly recommends against doing any kind of genital surgery on the child. The old way of thinking is that, "it will all be ok, if the surgery is done while the child is very young". This is not true, and there are many who believe they should have gotten to decide what to do.

After saying all this, I bet you already knew most of it, but I thought I would go over it just to be sure. But there are a few things that are important to ask.

What are her goals for this procedure? There are three main things that a doctor deals with, with any penis repair or alteration. These are: function, sensation, and appearance, and they do not come hand in hand.

Now if the doctors main concern was sexual sensation there would be no surgery in the first place because any surgery leaves scar tissue and that scar tissue will not be providing much sensation.

The second is function, usually the main goal of hypospadias repair surgery. Basically, can he pee standing up? Will he be able to have sex, and reproduce normally?

The third exists in between the first two, appearance. Does the penis look like a normal penis. Now depending where you live, normal is not the same. For example in the US "normal" is circumcised, so the foreskin will be cut off and used to extend the urethra opening to the tip of the penis.
While normal in the UK is intact. So skin from the inside of your sons mouth will be used to extend his urethra, and (if needed) some will be used in a restoration surgery on your sons foreskin, if it is not complete.

So the kind of surgery, and the kind of result you will find, is based on where the doctor puts the importance. You cant really put priority in all three at the same time. So its important to find out EXACTLY what the doctor intends to do, and see if that matches up with what you want. (Or much more importantly, what you think your son wants)

Again, as a guy who has been through this, dont do it if there is not an extreme functional problem. Personally I care more about sensation in the bedroom, then if the creepy guy standing next to me at the urinals can see that I have a straight pee stream.

Good luck with this hard decision, if you have any further questions, feel free to OM me.


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## tlh (Oct 10, 2007)

i would decide based on how severe the hypospadia is.my dad has lived for 66 years with one and has had no problems.also i would consider using an alternative to the foreskin such as tissue from the mouth,scrotum or another part of the body to keep the penis as normal as possible.if foreskin tissue must be used you could have the foreskin reconstructed using the GRAP repair or simmilar surgery.

http://www.cirp.org/library/restoration/gilpin1/

GRAP repair: single-stage reconstruction of hypospadias as an out-patient procedure.


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## Frankly Speaking (May 24, 2002)

I fully agree with what Perspective wrote and only want to expand on it.

First, you have to consider the degree of hypospadias. It varies from a slightly enlongated urethral opening to the urethral opening being at the base of the penis or lower. Obviously, the more extreme cases require correction but the lesser cases do not and may not even be desireable.

The current trend is for parents to want their child's genitals to be perfect but trying to achieve perfection can be more damaging than the imperfection itself. The majority of men who have the lesser forms of hypospadias that have not been surgically corrected are happy and content with their penises and have no intent to have it corrected. If they are not totally satisfied, they are not sufficiently dissatisfied to have the procedure done. They also are not generally dissatisfied to risk the problems that can and do come with the procedure.

With this in mind, the important considerations are: (1) Will my son be able to urinate normally and (2) Will my son be able to successfully reproduce? Any other considerations are unimportant.

If the answers to the questions lead to surgical correction, the surgeon can now also repair/preserve the foreskin. Many doctors are not familiar with this technique. Here is more information: http://www.cirp.org/library/restoration/gray1/

Frank


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## MCatLvrMom2A&X (Nov 18, 2004)

Questions to ask:

How much if any foreskin are you planing on removing/using in the repair?

Is there any way to not use it at all?

Insist on leaving as much as possible.

there are many forms of hypo and for the mildest I would leave it for the boy to decide on later. For the more severe it should be fixed so that the child can have as normal a life as possible.

Here are some links for you:
Hypospadious: http://www.cirp.org/library/restoration/gray1/

Hypospadious: http://images.google.com/imgres?imgu...l%3Den%26lr%3D

Hypospadious: http://www.emedicine.com/PED/topic1136.htm

Hypospadious: http://www.medscape.com/content/2004...89956.fig4.jpg

Hypospadious: http://www.medscape.com/viewarticle/489956_8

Hypospadious graph: http://www.hypospadias-emotions.com/images2/hyposp6.jpg

for one of those links you will need to join but it is free and well worth the time to register for the pics and information.


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## 2lil'monkeys (Feb 18, 2008)

Thank you all. I've done a lot of reading on it, but I just wanted to hear advice from anyone who's been through it. I feel comfortable with our surgeon, who said she would leave as much as possible. From what I've been told, my son's case isn't mild (he has a chordee, which DH and I think should be repaired while he's still young). Anyway, I appreciate the info and will bring these issues up with our surgeon when we meet with her in June.


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## perspective (Nov 3, 2007)

Quote:


Originally Posted by *2lil'monkeys* 
Thank you all. I've done a lot of reading on it, but I just wanted to hear advice from anyone who's been through it. I feel comfortable with our surgeon, who said she would leave as much as possible. From what I've been told, my son's case isn't mild (he has a chordee, which DH and I think should be repaired while he's still young). Anyway, I appreciate the info and will bring these issues up with our surgeon when we meet with her in June.

Well there are option which do not involve using the foreskin. I have been though this myself, and unless its an emergency, dont do it, and if you need to do it, do what is the least invasive. Also, I strongly suggest to do more then have a list of questions and take what the doctor says. This is a complex issue and your doctor may not know everything. You should brush up and skim all the information you can find.

Basically when your talking to her, it shouldn't be Q&A session, it should be a books out, deep discussion.

Good luck, and I really hope all turns out of the best for your son.


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