1. What is hypospadias a disease? Hypospadias is one of the most common congenital malformations of the external genitalia of the urinary tract in children, affecting approximately 1 in 250 newborns or, roughly estimated, 1 in 125 live male infants, and its incidence is increasing every year with the influence of environmental factors and the use of assisted reproductive technologies. Hypospadias is defined as the termination of the normal developmental process of the urethra, prepuce and ventral aspect of the penis. This leads to the occurrence of a series of malformations, where the urethral opening may be anywhere on the body of the penis, or in the scrotum, or even in the perineum. Hypospadias is often associated with a downward curvature of the penis or a painful erection. If left uncorrected, patients with severe hypospadias are unable to stand to urinate and suffer from serious psychological disorders due to dissatisfaction with the appearance of the external genitalia and low self-esteem. 2.How to treat hypospadias? Hypospadias can only be treated by surgery! It is recommended that if you find hypospadias or abnormal appearance of the penis, you should visit a urology clinic for a clear diagnosis and sex hormone evaluation, and then choose surgery when appropriate. The aim of surgical correction is to approach the normal post-circumcision appearance, mainly including: (1) correction of the downward curvature of the penis, so that the urinary line is forward and the child can stand to urinate. (2) The urethral opening is located at or close to the normal opening. 3.What is the appropriate time to operate for hypospadias? According to the American Association of Pediatric Urology’s guidelines for the treatment of hypospadias, it is recommended that surgery for hypospadias be performed at 3-4 months of age. Due to the difference in ethnicity and the level of care of the family, our department recommends that surgery be performed on children around one week of age, but surgery can be performed earlier depending on the condition of the child’s penis appearance. 4.Does hypospadias affect fertility after surgery? Whether a man has normal fertility depends on the quality of sperm, not the appearance of the penis, although psychological factors play a role. After hypospadias surgery, the appearance of the penis is nearly normal, thus creating good conditions for sperm discharge. 5.Does anesthesia affect the brain development of children? Anesthesia is a relatively safe sacral anesthesia. The anesthesia that affects the brain development was relatively rudimentary a few decades ago, and the anesthesia with ether was prone to produce secretions that blocked the airway and caused oxygen deprivation and other accidents, thus affecting the oxygen supply to the brain and thus the brain development. At present, the level of anesthesia has been greatly improved. 6.What are the complications of hypospadias surgery? Hypospadias belongs to the more complex reconstructive surgery, and the postoperative complications mainly include urethral fistula, urethral stricture, urethral diverticulum, urethral split, and recurrence of hypospadias. Our department has been performing hypospadias surgery for nearly 35 years and is experienced in hypospadias surgery, with a small incidence of serious postoperative complications. The most common complication is urethral fistula, or urethral fistula for short. Urethral fistula has less impact on the child’s urinary physiology and is relatively simple to repair again after surgery, so families do not need to be overly nervous. Postoperative complications are more important in the management of urethral strictures, which need to be treated early, and the family needs to observe the child’s urination more carefully after surgery. If left untreated, persistent urethral stricture will lead to more difficult urinary dysfunction and recurrent urinary tract infections.