# hypospadias



## kailove (Apr 8, 2005)

hello, i'm new to this, has anyone had a son born with hypospadias? my son is 5months, and has been to 2 urologist who want him to have surgery to normalize his penis, i know this is somewhat common, my 2 cousins had it, but i am still uncomfortable with the procedure so young, especially hearing about sometimes needing a second surgery.


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## OnTheFence (Feb 15, 2003)

Quote:


Originally Posted by *kailove*
hello, i'm new to this, has anyone had a son born with hypospadias? my son is 5months, and has been to 2 urologist who want him to have surgery to normalize his penis, i know this is somewhat common, my 2 cousins had it, but i am still uncomfortable with the procedure so young, especially hearing about sometimes needing a second surgery.

From what I understand, surgery is needed to correct the problem or else problems can come about causing infection and pain later on. Some drs want to do the surgery early on but most wait until around the year. I have had two friends with boys that have had the surgery to correct this. One had it severely and had surgery when he was 6m old, the one had it less severely and had surgery at a year. The surgery was a bigger deal for them than their children. The babies easily recovered and their penis' looked like they had been circumcised. It was also out patient, the mom that was nursing was able to nurse her baby in recovery.
Unfortunately this is one of those situations when surgery is best so not to create problems in the future.


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## crysmomofthree (Mar 18, 2004)

my third son has mild hyposadius, his urethra come out in the bottom third of the head of his penis (I hope I explaned it right) no one has suggested surgery. The pediatric urologist who saw him at birth recommended that we not circumcize (we weren't anyway) in case he needed wanted reconstructive surgery later. He is 20 months and has had no problems and we (me and the drs) don't anticipate any. good luck with your decision,
crystal


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## Full Heart (Apr 27, 2004)

How bad is it? What are the drs reasonings for the surgery? If its cosmetic only I wouldn't have it done. If there is some legitimate medical reason I would consider it.

My dh has hypospadias as did his grandfather. It hasn't caused any problems medically. We decided that if we had any boys with it we wouldn't have surgery unless it was a very bad. If there were big problems that needed to be corrected I would have to weigh wether or not the healing would be better now or if we waited. Since there will be a lot of growth between nb and adult will the growing cause problems to the site perhaps causing it to open? I would have a lot of questions. Of course as he grows it becomes more sensitive so that you have to take into account. My dh had his foreskin removed at 12 and it was very difficult. I can only imagine what a more indepth surgery would have done.

Hope you get some good responses.

michelle


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## Frankly Speaking (May 24, 2002)

Kailove:

I post on "The Case Against Circumcision" forum and was alerted to your son's problem by another member. There is a thread there about your son's problem and I will be most happy to help you. I have a good bit of experience with this and have helped quite a few mothers. Here is the thread:

http://69.20.14.30/discussions/showt...88#post2932388

I do need more information about your son's problem to give you accurate answers. Most specifically, exactly where does your son's urethra exit and is there any deformation of his foreskin?

I can also give you information on other issues of hypospadius as you need them and various surgical techniques including the latest developed in Scotland that is far less invasive than the typical repair procedure done in the US.

I don't post here, so if you will follow the link above, you will have my immediate attention.

.

On the Fence: It is rare that the repair surgery would be an outpatient procedure. That would be the case only in the mildest of cases and in those cases, surgery would usually be contraindicated. Many, if not most cases should not have surgery at all. Surgical repair of minor cases of hypospadius is a recent thing and is cosmetic only in the vast majority. There are many adult men with hypospadius who have no intention of surgery and wouldn't have it even if it were free. Considering that every invasive surgical procedure has risk, that is something that should be seriously considered.

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crysmomofthree: There is a new procedure developed in Scotland that has superior results, a shorter recovery time and equal or better results than the procedure normally offered here in the states. It also does not use the foreskin for donor material so the foreskin is saved. This is a procedure that can be performed on both children and adults. You may want to make note of that in case your son ever does want the repair.

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Full Heart: The opening will not open further than it already is. In other words, it will not get worse, nor will it get better with time.

Frank


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## Trishy (Oct 15, 2002)

My ds1 has a mild epispadias that I have chosen not to have repaired. He did have surgery to correct an inguinal hernia along with the epispadias but I decided not to do the repair of the epispadias. It was an outpatient procedure but after researching it I couldn't do it. There is a great yahoo group with loads of information from the Hypospadias and Epospadias Association where you can talk to some men that have it and get some wonderful, experienced advice:

http://groups.yahoo.com/group/hyposp...diasassnforum/


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## Full Heart (Apr 27, 2004)

Frankly Speaking: I was refering to if surgery was done would the site open up with growth. I wasn't very clear.

Michelle


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## averymybaby (Jun 14, 2004)

My DH had it at birth and had surgery to repair it I'm guessing around 6 months (his parents are vague and forgetful :LOL). If it is recommended that you wait longer, you might want to think about that.. either the surgeons that worked on him didn't do a very good job, or they should have waited until he was a year. He was circumcised anyway but the "correction" is very noticeable.


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## letabug (Feb 25, 2004)

my oldest son has a mild case that only would require surgery #1 if when he is erect the tip dips down or #2 cosmetic, which neither are an option as of now but I have to keep an eye on it until he is around 3. My son was circumcised (I know, I know...I didn't know better then) and I found the problem at home...







: He also has to go to the uriologist once a year until he is 5. I was told if it is a mild case they want you to wait until their first birthday. Infection is the major problem apparently if it needs to be fixed. I was given lots of internet sites w/ message boards and a few yahoo groups too. I have since thrown the paper out b/c the degree is so minor. But I am sure you can do a search on it. Hope it helps to know your son isn't the only one...I was told it wasn't very common and ran in families so I felt like I was alone the hospital didn't even have any local references or anything...the children's hospital was great and made sure we understood that it is very common actually.


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## Frankly Speaking (May 24, 2002)

Quote:


Originally Posted by *Full Heart*
Frankly Speaking: I was refering to if surgery was done would the site open up with growth. I wasn't very clear.

Michelle


That is not known. It depends on the extent of the scar tissue and where it is located. Scar tissue is not elastic so substantial scarring could cause later problems. There is no way of knowing until long after the surgery. I had something similar. I have several indicators that I had meatal stenosis as a toddler. I'll never know for sure as my mother passed well before I became familiar with this issue and learned of the indicators. Meatal stenosis is a common complication of circumcision and produces scarring around the urethral opening. (the meatus) One of the later life indications of this is a lump around the meatus in adults. I have one of those lumps that was very firm as a teen but over the interviening 30 years, it has softened somewhat. In my early 20's, I had to have the meatus stretched as it was causing problems. It was a very painful procedure.

Quote:


Originally Posted by *letabug*
My son was circumcised (I know, I know...I didn't know better then) and I found the problem at home...

I suspect you have an actionable legal case against the doctor that did the circumcision. In a circumcision, the foreskin is first stripped away from the glans. At this point, the doctor should inspect the glans for any sign of hypospadius/epispadius and if there is any sign, should immediately stop as the most common repair procedure uses the foreskin for donor material for the repair. This is prima facie evidence that the doctor was inept and negligent or unqualified to perform the procedure. If you would like to investigate your legal recourse, let me know and I'll refer you to an attorney that specializes in cases like this.

Quote:

I was told it wasn't very common and ran in families so I felt like I was alone the hospital didn't even have any local references or anything...the children's hospital was great and made sure we understood that it is very common actually.
The incidence of hypospadius is about 1 per 1,000 male births, so really, not so common. However, it does seem to be more common in some localities. The latest theory about it is that it is caused by estrogen in the water supply and the evidence possibly bears this out. Estrogen can get into the water supply from two main sources. First, if your city takes it's water supply from a river that is down stream of another city, the estrogen would come from women using birth control in the upstream city. It comes from sewage discharge. It can also come from large scale animal farms upstream of your city where the animals receive feed with estrogen hormones. This explains why the condition is more prevalent in some localities than others. It could also possibly explain why it seems to run in your family if they were all birthed in the same area.

No genetic element to hypospadius has been identified and overall, there seems to be no hereditary component to the condition.

Frank


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## kailove (Apr 8, 2005)

my sons case is 2 1/2,3 out of 5 i've been told.he had an ultrasound, and internally everything is fine.i'm told it's more about his emotional state when he is older, and that sex may be difficult for him as an adult,which is my concern, that he have a healthy and comfortable adult sex life. my problem is partially surgeons that talk about my son hating me when he is thirteen,having to pee sitting down and becoming a basket case, and that he(the surgeon) is "all about big penis'" that my worry would be about that? i've also had contradicting info from surgeons about sperm production, one told us we would never become grandparents, and the other said not true. can a surgeon, sounding more like a sales person predict his emotional state years from now? thanks for the web info


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## orangebird (Jun 30, 2002)

I would get a second third and fourth opinion on this. There are cases where surgery is necessary but doctors in the US are notorious for wanting to fix nearly everything on the penis with circumcision and/or surgery. Sometimes the best thing to do with hypospadius is leave the guy intact. But there is a wide variation of hypospadius so I have no idea what your son's is like. Get some more opinions. Or even better find a urologist who is anti circ to begin with so he won't be one of the ones who are fast to cut the penis apart for everything. Not saying you don't need surgery for him, but make sure you get the opinion of someone who is "OK" with intact penises to begin with.

I am curious what a doctor said about hypospadius and sperm production and given there were such a correlation how on earth surgery would fix that?


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## Full Heart (Apr 27, 2004)

Quote:


Originally Posted by *kailove*
my sons case is 2 1/2,3 out of 5 i've been told.he had an ultrasound, and internally everything is fine.i'm told it's more about his emotional state when he is older, and that sex may be difficult for him as an adult,which is my concern, that he have a healthy and comfortable adult sex life. my problem is partially surgeons that talk about my son hating me when he is thirteen,having to pee sitting down and becoming a basket case, and that he(the surgeon) is "all about big penis'" that my worry would be about that? i've also had contradicting info from surgeons about sperm production, one told us we would never become grandparents, and the other said not true. can a surgeon, sounding more like a sales person predict his emotional state years from now? thanks for the web info

My husband can pee standing. He had to figure out how to hold his penis so the urine stream would go into the toliet and not into his hand. But he can do it. I perfer men to pee sitting anyway and dh does this at home...ever seen where the spray goes? Ewww. And dh doesn't hate his parents. He was afraid that a woman would be too superficial to love him despite the hypospadias (thanks to the porn industry for that sterotype). Of course that also proved to be not true. Sex is not painful for him either. Although that probably varies from man to man. It also has not stopped us from having kids (we are pg with #6 and our oldest is 7!). Half the time I wonder if it makes us more fertile lol. My dhs opening is about a 1/3 the way down his shaft. So pretty significant.

I would say don't see a surgeon unless you want surgery. Thats what they are in the business of and they will recommend surgery. Good Luck!

Michelle


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## jacobhiggins (Jun 11, 2005)

I'm a 21 year old male who was born with severe hypospadias. I had three surgeries to try to correct the problem. One when I was a baby, one when I was twelve, and one when I was 19. Luckily, the last one was a success, but I really had wished I had gone to a good doctor when I was a child and had it taken care of. It caused a lot of problems for me growing up. Pyschologically it is pretty true what the doctors say, it will effect you, and for me it did drastically. I would suggest you get it taken care of when your son is a child, he might never know, but if he did, he would be very thankful you did not wait until he was older and was aware of the situation. Make sure you go to a good urologist to have it done, the doctor that I went too for my first two operations was not experienced with Hypospadias and caused more harm then good.


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## claud (Dec 12, 2001)

Quote:

The incidence of hypospadius is about 1 per 1,000 male births, so really, not so common. However, it does seem to be more common in some localities. The latest theory about it is that it is caused by estrogen in the water supply and the evidence possibly bears this out. Estrogen can get into the water supply from two main sources. First, if your city takes it's water supply from a river that is down stream of another city, the estrogen would come from women using birth control in the upstream city. It comes from sewage discharge. It can also come from large scale animal farms upstream of your city where the animals receive feed with estrogen hormones. This explains why the condition is more prevalent in some localities than others. It could also possibly explain why it seems to run in your family if they were all birthed in the same area.

No genetic element to hypospadius has been identified and overall, there seems to be no hereditary component to the condition.
Frank[/QUOTE]

Actually the incidences of hypospadias are much more common. Some estimates are at 1 in every 125 boys born. It is the most common birth defect in boys. My son has hypospadias and we have not had any correction for it as it is mild.
I also wanted to mention that, unlike the UK, almost all surgery done in the United States is an outpatient surgery. There are many different techniques for surgery and variations of the Snodgrass technique are common in which the urethral plate is incised and the foreskin is not used. In more severe cases the foreskin is needed to make up the extra skin and in repeat surgeries where the repair has not held up, skin can be taken from the inside of the cheek or from the bladder.
The reason hypospadias is caused is unknown although there are probably both genetic and environmental reasons depending on the case. I know of families where 2 sons have it. We suspect my husband has had repair but have not taken him to be checked yet. I also have a son with penile torsion. These incidence point to some sort of genetic link. I think Dr. Snodgrass's office in Texas is doing some research into the genetic link although we chose not to take part in the study.
To jacobihiggins: You should check out www.heainfo.org and get support from others going through what you're going through. I serve on the board of directors of the Hypospadias and Epispadias Association and we are working hard on getting information out to parents and others who are dealing with these issues.


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## bsymomof7 (Aug 3, 2005)

I had a son with this problem. He also had another complication that I don't remember how to spell that looked like he had a gather stitch running from the top to the bottom of the shaft. This was our greatest concern because it would make erections difficult, and painful, if not impossible, .

We waited until he was a year to do the surgery and it was schedualed for when there would be a pediatric urologist that specialized in this was visiting. (we live in Alaska, not to many specialists up here) It was supposed to be outpatient but there were complications so we stayed over night. There have been no other problems. He's now 6yr old.

He is the only one of my boys that is circumsized. I consider myself a well informed, contientious mom, and I'm glad that I did the surgery when he was a baby. Children can be very cruel, being different in that way would be very hard. I have three children with umbilical hernias that I have not corrected. My nine year old girl has just recently been hurt by teasing.

Being a good mom is not always about being the most organic, natural, granola mama around. Often it's about going against the grain, even when that means joining "mainstream" medicine, instead of following our peers in the natural parenting movement.

Follow your heart, it will let you know which choice is right for you and your son. There are many opinions but you will make the best choice for your family.


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## mother two ways (Aug 30, 2006)

[/QUOTE] my son was born premature and had hypospadias. It was repaired with no problems at all at 7mo. my advise is to research your dr.'s back ground with this surgery and go with it he'll thank you later on. Mat had no after affects at all and i beleive that was because his dr did a good job!


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