Age of surgery: 6 months – 18 months
Risk of anesthesia
Psychological reasons: 3 years old
Principles of treatment for hypospadias.
1. correction of penile curvature.
2. normal or near normal penile appearance.
3. no bladder fistula.
4. no narrowing of the urethra
5, free grafts are not preferred.
6.Chromosome examination is required for cleft scrotum.
Surgical objectives.
1, to establish a functional urethra
2, formation of a cleft-like opening in the orthodontic urethral opening.
3. formation of a beautiful penile head
4, correction of penile curvature.
5, correction of penile scrotal inversion.
6.Beautiful skin coverage.
7.Excision of excess foreskin.
Long-term goals of surgery.
1. a functional urethra: normal urination, normal ejaculation.
2. acceptable penile appearance.
3, normal sexual function/normal intercourse.
4. normal psychological and social behavior.
Other aspects of hypospadias surgery that require attention.
a. drainage issues.
b. Bandaging issues.
c. Basic principles to prevent complications of hypospadias surgery:
1. do not go beyond your capacity.
2. choose the appropriate surgical method for each case.
3. do not underestimate the complexity of hypospadias
4. careful anatomical manipulation.
5. standardize each operative step.
6. not to remove tissue until it is truly and completely confirmed that you do not need it
7. avoiding excessive tension in the incision.
8. covering the urethra in multiple layers.
9. Avoid testosterone treatment.
d. Points to note for surgery according to the American:
1, early surgery (under 1 year).
2.Careful decortication to protect the skin and blood supply to the urethral plate.
3.Check for penile curvature (manual erection test).
4.Careful hemostasis.
5.Use of good sutures and magnification.
6, suturing a non-leaking urethra
7, covering the urethra.
8, diversion of the urinary stream.
9, antibiotic treatment.