Our Summary

This research paper is about a specific variant of a birth defect called hypospadias, which is when the opening of the urethra (the tube that carries urine out of the body) is on the underside of the penis instead of the tip. This variant is called “Megameatus intact prepuce” (MIP). It’s usually identified and fixed after a baby is circumcised, but circumcision is often not recommended for boys with other types of hypospadias.

The researchers wanted to see if the complications from repairing MIP hypospadias were due to the specific characteristics of this variant, or if they were caused by the circumcision. To do this, they compared data from boys who had been circumcised and then had MIP hypospadias repaired, to boys who had been circumcised and had other types of hypospadias repaired.

The study found that the rates of needing another operation were about the same for both groups. This suggests that the complications aren’t caused by the specific characteristics of MIP hypospadias, but rather by the circumcision.

The researchers note that their study has some limitations - for example, they used medical records to determine whether the boys had MIP or another type of hypospadias, and it’s possible that these records weren’t entirely accurate. But they believe their findings still provide strong evidence that circumcision is likely the cause of the complications when repairing MIP hypospadias.

FAQs

  1. What is the “Megameatus intact prepuce” (MIP) variant of hypospadias?
  2. What was the purpose of the research study on MIP hypospadias and circumcision?
  3. What were the main findings of the study on MIP hypospadias repair complications?

Doctor’s Tip

One helpful tip a doctor might tell a patient about hypospadias repair, specifically for boys with MIP hypospadias, is to consider avoiding circumcision before the repair surgery. This is because circumcision can increase the risk of complications during the repair process. By avoiding circumcision, the likelihood of needing additional surgeries or experiencing other complications may be reduced. It is important for parents to discuss this option with their healthcare provider to make an informed decision about the best course of action for their child.

Suitable For

Overall, patients who are typically recommended hypospadias repair are infants and young boys who are diagnosed with this birth defect. In particular, those with MIP hypospadias may be recommended for repair, as well as those with other types of hypospadias who have not undergone circumcision. The decision to recommend surgery for hypospadias repair is typically made by a pediatric urologist or other specialist based on the severity of the condition and the potential impact on the child’s health and quality of life.

Timeline

Before hypospadias repair:

  • A baby boy is born with hypospadias, with the opening of the urethra on the underside of the penis instead of the tip.
  • The condition may be identified during routine physical exams or shortly after birth.
  • The baby may undergo circumcision, which can complicate future hypospadias repair procedures.
  • The family may be referred to a pediatric urologist for evaluation and treatment options.

After hypospadias repair:

  • The baby undergoes surgery to correct the position of the urethral opening.
  • The surgery may involve moving the opening to the tip of the penis and reconstructing the surrounding tissue.
  • The baby may experience discomfort, swelling, and temporary changes in urination patterns following the surgery.
  • Follow-up appointments are scheduled to monitor healing and address any complications that may arise.
  • Long-term outcomes, such as urinary function and cosmetic appearance, are assessed over time to ensure the success of the repair.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with the hypospadias repair surgery for MIP hypospadias?

  2. What is the success rate of the surgery for MIP hypospadias?

  3. How long is the recovery process expected to be after the surgery?

  4. Are there any long-term effects or implications of having MIP hypospadias repaired?

  5. Will there be a need for follow-up appointments or additional procedures after the initial surgery?

  6. What alternative treatment options are available for MIP hypospadias if surgery is not recommended?

  7. How experienced are you in performing hypospadias repair surgeries, especially for the specific variant of MIP hypospadias?

  8. Can you provide me with information on the specific techniques or approaches you will use for the surgery?

  9. Are there any lifestyle changes or precautions I should take before or after the surgery to ensure the best outcome?

  10. What is the expected outcome or prognosis for a patient undergoing hypospadias repair for MIP hypospadias?

Reference

Authors: Herzberg H, Ben-David R, Mendelson T, Dubi-Sobol A, Bashi T, Savin Z, Ben-Chaim J, Bar-Yosef Y. Journal: J Pediatr Urol. 2024 Feb;20(1):38.e1-38.e6. doi: 10.1016/j.jpurol.2023.10.011. Epub 2023 Oct 14. PMID: 37891026