# Do any of you have a son with Hypospadias??



## maylea_moon (Mar 4, 2005)

My son was born 4 days with a very mild form of Hypospadias (glanular). Pediatrician says he will need to be circ'd around 6 months in order to repair it? He says that if it's not repaired (they do use general anesthesia and some of the foreskin to repair it) then he could end up with infertility issues...

i'm torn and confused, anyone have a son with hypospadias that they DIDN'T have to circ?


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## Fellow Traveler (Jan 8, 2008)

Quote:


Originally Posted by *maylea_moon* 
My son was born 4 days with a very mild form of Hypospadias (glanular). Pediatrician says he will need to be circ'd around 6 months in order to repair it? He says that if it's not repaired (they do use general anesthesia and some of the foreskin to repair it) then he could end up with infertility issues...

i'm torn and confused, anyone have a son with hypospadias that they DIDN'T have to circ?

It's difficult to say without knowing how bad it is. You have a lot of time so I would seek out another opinion. It is my understanding that mild forms don't require repair but that is a coarse understanding.


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## Raelynn (Apr 7, 2007)

Mild hypospadias that does not involve chordee or other physical problems, does not need to be repaired. Hypospadias is common (1 in 150 boys have it to some degree). Unless the urethral opening is way down the shaft towards the scrotum, all that would be different would be the angle, but men are able to procreate just fine even if their urethra isn't exactly on the end of the penis.

I agree with the PP, get another opinion. Perhaps you could contact Doctors Opposing Circumcision to find a foreskin-friendly urologist.


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## mama24-7 (Aug 11, 2004)

Quote:


Originally Posted by *Raelynn* 
I agree with the PP, get another opinion. Perhaps you could contact Doctors Opposing Circumcision to find a foreskin-friendly urologist.

this was going to be my suggestion. another idea would be to contact Marilyn Milos at NOCIRC. She's a nurse & may give you her opinion as well as put you in touch w/ foreskin-friendly docs for a 2nd or 3rd opinion.

good for you & your son to investigate this rather than just take the word of one doctor. they are not known for wanting to preserve the prepuce.









good luck & let us know how you make out!
sus


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## Quirky (Jun 18, 2002)

I know it's a huge shock, but really, there's no hurry to fix it. As long as he can pee OK, then it's just a cosmetic issue. Really, it could wait all the way until he's fully grown to fix it (and there's a lot more to operate on at that point when you know what the penis is going to look like!)

Also, the idea that you need to circumcise to fix a mild hypospadias is outmoded. In Europe, they do surgeries to reconstruct incomplete foreskins because they understand that the foreskin is an important, functional part of the penis. Unless the hypospadias is so bad that there's no help but to use the foreskin to reconstruct the penis, it doesn't need to be removed.

I would do a LOT more research before I let a doctor take a knife to my baby's penis when there's nothing that has to be fixed right away. And I would make a real effort to search out a doctor who's truly informed about the intact penis and how to do any reparative surgery in a way that will keep the foreskin as intact as possible. Keep in mind that American doctors, in general, are extremely ignorant about the foreskin so even urologists often don't know the foreskin's functions.

Scroll down here for medical journal papers:

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

And try to relax and enjoy your sweet little newborn, mama! Really, truly, the hypospadias issue can wait. You have lots and lots of time -- years, if you need it -- before you need to make any decisions. Bigger, older children tolerate surgery better, have more penis to work with, and can have adequate pain relief afterwards. There's just no need to rush anything.


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## dickybird (Jan 31, 2008)

My son (now 2.5-yr-old) was born with glanular hypospadias. I was really upset for a while after his birth, thinking that I must have done something during pregnancy that caused it. Now I think he's just fine the way he is.

We discussed it with his pedi at the time, and in his opinion it didn't require surgery. He did refer us to a urologist for a second opinion, and the urologist agreed that surgery would be for purely cosmetic reasons. He mentioned that he has often seen adult men with glanular hypospadias come into his office for other reasons, and they had no idea that there was anything different with them, had kids, etc. We had already decided we weren't going to circ, since that would be for cosmetic reasons, so why subject our baby boy to painful unnecessary surgery? Also, general anesthesia is really not good for babies, so best to avoid it if at all possible. We figured it would be his choice if he decided that he wanted it repaired when he was older.

Anyways, you have my sympathy; I know it can be hard to struggle with these decisions when you're taking care of a newborn! Feel free to ask me questions.


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## MCatLvrMom2A&X (Nov 18, 2004)

For mild hypo there is no medical need for surgery. It is purely cosmetic. As such it should be up to the owner if he wants it fixed later.


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## darien (Nov 15, 2005)

Quote:


Originally Posted by *MCatLvrMom2A&X* 
For mild hypo there is no medical need for surgery. It is purely cosmetic. As such it should be up to the owner if he wants it fixed later.











My older son has mild hypospadias. My ob and his pedi said that infertility would not be an issue.


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## MCatLvrMom2A&X (Nov 18, 2004)

Infertility comes into play when the hypo is so bad the urethral opening is on the very shaft of the penis. In that case it can make it difficult for the sperm to go where they need to during sex. Usually when the hypo is that bad the penis is also bent, chordee, and that can make penetration difficult or impossible depending on the degree of bend.


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## brant31 (Jan 11, 2009)

Quote:


Originally Posted by *maylea_moon* 
My son was born 4 days with a very mild form of Hypospadias (glanular). Pediatrician says he will need to be circ'd around 6 months in order to repair it? He says that if it's not repaired (they do use general anesthesia and some of the foreskin to repair it) then he could end up with infertility issues...

i'm torn and confused, anyone have a son with hypospadias that they DIDN'T have to circ?


No, but I have a penis with hypospadias. I've had it all my life, along with my foreskin. Neither has caused me a moment's bother. (Well, not entirely true... I was celibate well into my 20's because of concern how each characteristic would be perceived, moreso the former than the latter. Turned out neither has ever been worth thinking about. But no health concerns.)

The idea that glanular hypospadias requires surgical repair is a direct holdover from the intersex hysteria of the 1970's, the belief that children need to be surgically corrected to meet the ideal of their gender. Ironically, the ideal for males means less than they're born with, but in any event it did seem that society and the medical profession in the US were finally getting away from this "cookie cutter" idea about genitalia and finally accepting that there is a spectrum of what's normal and healthy. And mild hypospadias is clearly within the norm for boys.

I'll add that I have seen several glanular hypospadias repairs, and I'll take what I've got over that, any day. They look like little episiotomy scars and wholly unnatural.

Doctors also seem to have a bizarre notion that the foreskin is just like a piece of spare cloth that you can nip and clip and even completely remove without consequence. The truth is that the foreskin is highly evolved and specialized, with some nerve endings running parallel to the shaft and some, particularly near the supremely innervated mucocutaneous junction, running perpendicular. That is also where much of the smooth muscle tissue is.

It doesn't take a PhD anatomist to understand that even nicking into this tissue severs some of the nerve function and much of the whorled, closing function of the infantile prepuce. It is a closed, interconnected system that is easily short-circuited by slicing into. Why most doctors don't "get" this instinctively is a troubling mystery. This system is intact even for boys with hypospadias. The muscle tissue may be aligned differently, but the nerves are certainly all there.

Some glanular hypospadias is so mild that it can be seen only by retracting the foreskin. My friend Kevin surprised the heck out of me when he mentioned that he has hypospadias, as I'd seen him nude at the pool shower and have come to know the "cowl"-like appearance of a typical hypospadic foreskin. I'm always interested in hypospadias and it wasn't exactly politic of me to ask, but I did and he showed me that there is no trace of hypospadias when his foreskin is down; in fact, it's long both in front and in back. But retracted, he looks just like me when I am. And neither of us has a frenulum, to speak of. My point is that the variants in human anatomy can be both extensive and normal.

As for damage to the foreskin from using "bits" of it to repair hypospadias, I can only rely on the experience of 2 close friends of mine. Both were having foreskin problems in their 20's within a few months of each other, for separate but understandable reasons. Both were told repeatedly that circumcision was the only option. But they did their homework, and each eventually found doctors willing to try a surgical repair. The one in San Diego opted for a Z-plasty with 3 incisions, and the friend in Seattle opted for a similar operation with 4 incisions. This procedure _removes no tissue_, just makes nicks and then re-stitches the foreskin more loosely.

Even so, both friends reported dramatic loss of sensation, which has never fully come back. Once the ring of nerves and muscle tissue was compromised, the body had to re-wire itself. It hasn't been that big an impediment; both married their girlfriends and each now has 2 kids. But they remember what their foreskins were like before, and regret taking them for granted. Neither wishes he'd had a circumcision, but it makes me sad when the one friend refers to his foreskin now as his "overcoat".

Please research this thoroughly before deciding whether to put your little one through a surgery he really may not benefit from.


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## maylea_moon (Mar 4, 2005)

thanks so much everyone! i've been doing a lot of research on it and circing for his mild hypospadias really is still just for cosmetic reasons. i will let him decide when he is an adult whether he wants the surgery or not.

brant31 - thanks so much for sharing your story!


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