Chapter: Paediatrics: Paediatric Surgery
Paediatrics: Hypospadias
Hypospadias
Hypospadias affects 71/350 male
births. Characterized by an abnormal position of the external urethral meatus
and is classified according to the location of the meatus (penis down to the
scrotum; see Fig. 23.21). Severe forms of hypospadias may be associated with
chordee—a ventral curva-ture of the penis. The most common consequences of
hypospadias are difficulty urinating while standing and a cosmetic appearance
of the penis that differs from that of other boys. Sexual function is not
affected unless chordee, which may cause painful erections, is present.
Hypospadias advice
•
Make
sure you document the diagnosis in the notes.
•
Tell
the parents not to circumcise the
child.
•
Give
the parents a letter stating this advice.
•
Refer
the child to a paediatric surgeon.
Surgery
Surgical correction involves straightening of any chordee and reconstruc-tion of the urethra to the glans. This may involve tubularizing skin from the prepuce so circumcision is contraindicated. The correction can be completed in one or more operations during early childhood.
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