Treatment of hypospadias

  Hypospadias is a developmental malformation of the urethra in which the opening of the urethra does not reach the normal position of the tip of the glans, but opens on the ventral side of the penis in the pathway from the proximal end of the normal urethral opening to the perineum.  Except for a very small number of cases in which the opening of the urethra is located at the head of the penis and there are no obvious abnormalities in the penile shape and distribution of the foreskin, hypospadias requires surgical treatment. Due to the high incidence of postoperative complications, especially urethral fistula and stricture, the surgical approach to hypospadias has always been a hot topic of clinical discussion, and more than 200 surgical approaches have been reported so far, but there is not yet a single procedure that is satisfactorily accepted by all physicians.  The criteria for surgical cure of hypospadias are: 1. complete correction of the downward curvature of the penis; 2. urethral orifice located in the positive position of the head of the penis; 3. near-normal appearance of the penis, such as the condition after circumcision; 4. ability to urinate standing up and to have normal sexual life in adulthood. Due to the abnormal penile appearance and urination of hypospadias, which can bring adverse effects to the psychological development of the affected children, the age of surgery is usually 6 months after birth.  For children with small penile development, chorionic gonadotropin can be applied before surgery to promote penile development and also lengthen the penis so that the opening of the urethra can be moved relatively forward to reduce the severity of hypospadias.