I have not been able to contact you online for a long time because I was away studying and I was too busy at work. Whenever I see the eager eyes of parents at the clinic, I thought I’d better squeeze in some time to talk to you all. When I first graduated, hypospadias was less common, but now, cryptorchidism and hypospadias have become major congenital diseases of the pediatric urinary system. It’s hard to have a big fat baby in October, but it’s really fatal when something goes wrong in this critical area alone. According to current statistics, the incidence of congenital hypospadias is gradually increasing, with about 1 case in every 250-300 male babies. Nearly 20 million children are born each year in the country, and about 30,000 have hypospadias, and there are about 200 doctors nationwide who can do hypospadias surgery, with less than 50 of the real best. They are usually concentrated in top hospitals such as Beijing, Shanghai, Huaxi and Shenyang. Only our urology department in Dalian is currently able to perform orthopedic surgery, and there are only two doctors in our specialty, namely Dr. Liu Tianyong and myself. We have studied in top hospitals in China, such as Shanghai Xinhua, Fudan Pediatric Hospital, Shanghai Children’s Hospital, Shanghai Children’s Medical Center and Fukuoka Children’s Hospital in Japan, and participated in various domestic forums on hypospadias, which have opened up our horizons and improved our level. We treat about 50 patients with various hypospadias every year and have a deeper understanding of the disease. The 3 main features of hypospadias are: downward curvature of the penis; abnormal position of the urethral opening, i.e., the opening is anywhere other than the glans proper; and abnormal distribution of the foreskin, with a dorsal capitulum-like appearance and ventral absence. In the case of very severe hypospadias, the child needs to urinate in a squatting position, the scrotum is split against the scrotum, the penis scrotum turns and the testes are also abnormally developed, requiring chromosomal examination to clarify their gender. If hypospadias is left untreated, the affected child will not be able to have a normal sexual life in adulthood, and the psychological damage, in particular, is incalculable. Therefore, once a child with hypospadias is born, parents are very anxious and worried. They are afraid to meet people, and I have encountered examples in my work where the child and parents were discriminated against in the village because of this, and the couple ended up divorcing. There are more than 200 to 300 international procedures for the treatment of hypospadias, and none of them is yet the gold standard of treatment. This illustrates the diversity and complexity of hypospadias. Each case of hypospadias has its own uniqueness and cannot be replicated. Therefore, each case of hypospadias is a challenge and a test for the surgeon. A famous pediatric urologist in China once said that a surgeon who can perform hypospadias is a master. 6 out of 10 hypospadias are “heroes” if they can do it once. The prognosis of hypospadias requires a natural appearance, i.e. urethral opening, straight penis, usual urination, absence of urinary fistula and stricture, and focus on its appearance, as close as possible to the effect after circumcision. It is also important to have normal penile erection and ejaculation in adulthood. This hand surgery requires a very high level of skill and a long growth curve for the surgeon, so many doctors avoid this challenge. But someone has to solve the problem. When we see the heartfelt relief and gratitude of the parents after the child is cured, it makes us remain steadfast for the child. Even though we have had complications and multiple surgeries. However, this is science, this is disease, and doctors are not infallible, but will try their best. Many parents do not know enough about this disease, they think that the penis is just a little bit curved and the urethra is opened a little bit downwards, they have too high expectations. The age of surgery for hypospadias is usually between 1.5 and 2 years old, and some severe hypospadias require multiple surgeries to resolve the deformity. Also the most common complications of hypospadias are: urethral fistula and urethral stricture, urethral diverticulum, and penile hypospadias. The older you are, the higher the risk, and reoperation is not easy to heal. There are reports of repeated urethral fistula repair more than 20 times, which shows the complexity of this disease. The foreskin of hypospadias is very precious, it is the source of the new urethra and penile cover, must be treated in a specialized hospital, otherwise, once the surgery is performed again, it may be necessary to take material from other parts. If you want to know more about hypospadias, you can check the information online or you can talk to us at the hospital. Reach a consensus, and the doctor and patient will work together to keep your child healthy and happy!