Our Summary

This paper is a review of recent developments in the field of reconstructive urology, specifically focusing on surgeries for adult hypospadias, a condition where the opening of the urethra is on the underside of the penis instead of at the tip. The article talks about how doctors manage problems after surgery, tracks patient progress over a long period, and discusses the appearance of the penis after surgery. It suggests that how good the penis looks after surgery is subjective - what one person thinks looks good, another might not. Furthermore, it provides reassurance that the flow of urine generally improves as the patient grows from adolescence into adulthood after having the common type of hypospadias surgery.

FAQs

  1. What are the main themes in recent literature regarding hypospadias repair?
  2. What does recent literature suggest about the cosmetic results after hypospadias repair?
  3. What are the long-term results for uroflow improvement after hypospadias repair?

Doctor’s Tip

A helpful tip a doctor might tell a patient about hypospadias repair is to carefully follow postoperative care instructions to minimize the risk of complications and ensure optimal healing. This may include keeping the surgical site clean and dry, avoiding strenuous physical activities, and attending follow-up appointments as recommended. Additionally, discussing concerns about penile cosmesis with your doctor can help manage expectations and address any potential issues early on.

Suitable For

Patients who are typically recommended for hypospadias repair include those with congenital hypospadias, a condition where the urethral opening is not located at the tip of the penis, but rather on the underside. This can cause issues with urination and sexual function, as well as potential psychological and social implications. Surgery is usually recommended in childhood, but some patients may require repair in adulthood if the condition was not addressed earlier or if there are complications from previous surgeries. The decision to undergo hypospadias repair is based on the severity of the condition, the patient’s age and overall health, and the potential benefits of surgery in improving function and cosmesis.

Timeline

Before hypospadias repair:

  • Patient is diagnosed with hypospadias, a congenital condition where the opening of the urethra is located on the underside of the penis.
  • Patient may experience challenges with urination, sexual function, and self-esteem due to the appearance of their penis.
  • Patient undergoes preoperative evaluations and consultations with a urologist to discuss the surgical repair options.

After hypospadias repair:

  • Patient undergoes surgery to correct the position of the urethral opening and any other abnormalities present.
  • Patient may experience discomfort, swelling, and bruising in the genital area following surgery.
  • Patient is advised to follow postoperative care instructions, including wound care and restrictions on physical activity.
  • Over time, the patient’s penis heals and the surgical site improves in appearance.
  • Long-term follow-up appointments are scheduled to monitor the patient’s progress and address any postoperative complications that may arise.
  • Patient may experience improvements in urination, sexual function, and self-esteem following successful hypospadias repair.

What to Ask Your Doctor

Some questions a patient should ask their doctor about hypospadias repair may include:

  1. What are the potential risks and complications associated with the surgery?
  2. What is the expected outcome in terms of appearance and function after the repair?
  3. How long is the recovery process and what can I expect during this time?
  4. Will I need any additional surgeries or follow-up procedures in the future?
  5. What are the success rates for this type of surgery in adults?
  6. Are there any lifestyle changes or restrictions I will need to follow after the surgery?
  7. How experienced are you in performing hypospadias repair surgeries?
  8. Can you provide me with some before and after photos of patients you have treated for hypospadias?
  9. What are the potential long-term effects or complications that may arise from the surgery?
  10. Are there any alternative treatments or surgical techniques that I should consider before proceeding with hypospadias repair?

Reference

Authors: Vricella GJ, Coplen DE. Journal: Curr Opin Urol. 2016 Jul;26(4):363-8. doi: 10.1097/MOU.0000000000000298. PMID: 27152923