Penoscrotal hypospadias is a birth defect that occurs when a boy is born with the urethra (the tube that carries urine from the bladder) opening on the underside of the penis rather than at the tip of the penis.

This affects how urine flows normally, as well as potentially changing how the penis looks and works. Hypospadias is one of the most common conditions treated by pediatric urology and pediatric surgery.

There are multiple types of hypospadias; some boys have mild forms of the condition where the urethra opens near the tip of the penis, while others have much more complicated forms of hypospadias, such as penoscrotal (where the urethra opens close to the scrotum).

Prompt diagnosis and appropriate hypospadias treatment are critical for achieving satisfactory urinary and healthy development.

At Sarvodaya Hospital, we provide advanced treatment for hypospadias at our paediatric surgery hospital, which is led by the best paediatric surgeons in India and paediatric urologists who provide safe and effective care.

Hypospadias Symptoms

• The urethral opening is located on the underside of the penis
• Abnormal urine stream direction
• Curvature of the penis (chordee)
• Incomplete foreskin formation (hooded appearance)
• Difficulty urinating in a straight stream
• In severe cases, issues with future sexual function if untreated

Causes of Hypospadias

• Hormonal imbalance during fetal development
• Genetic predisposition
• Family history of hypospadias
• Environmental factors during pregnancy
• Disruption in urethral development

Diagnosis of Hypospadias

Diagnosis and evaluation of hypospadias are important in determining the degree of hypospadias, identifying any additional conditions related to the hypospadias, and choosing the optimal surgical correction of the hypospadias for both functional and aesthetic purposes.

• Clinical Evaluation: The paediatric surgeons in Noida will review the location of the urethral opening, the curvature of the penis, and the pattern of the foreskin to identify the presence of hypospadias and the type of hypospadias.

• Severity of Hypospadias: The evaluation and diagnosis of hypospadias will assist the surgeon in evaluating the degree of hypospadias and whether the child will require a single-stage surgical repair or two-stage surgical repair.

• Imaging (if needed): For complex cases, the surgeon may request additional imaging studies to evaluate the urinary tract for any associated conditions and assist in planning the best surgical treatment.

Treatment Options for Hypospadias

The treatment of hypospadias is done primarily through surgery. Its objectives include restoring normal urinary function, correcting any curvature of the penis, and creating a normal cosmetic appearance of the penis.

• Hypospadias surgery: The primary goal of this surgery is also to reconstruct the urethra and position the urinary opening at the tip of the penis. Due to the complexity of this procedure, the best pediatric surgeon in Delhi NCR is what is required.

• Single-Stage Repair: Most children with mild to moderate hypospadias can be corrected with a single-stage procedure, and most will have excellent functional ability and have an acceptable cosmetic result.

• Two-Stage Surgery (Complex Cases): Those children with more severe forms of hypospadias, such as penoscrotal hypospadias, typically will require a two-stage procedure to have the best functional and cosmetic results and to minimise complications.

• Post-Surgical Care: It is imperative that your child is monitored closely for any complications or issues following surgery to ensure optimal healing and to avoid complications such as infection, swelling, and urinary leakage.

• Hypospadias Surgery Age: Surgery for hypospadias is typically performed on infants between the ages of six months and 18 months since early intervention improves healing and long-term results.

Role of Early Intervention by Paediatric Surgeon

A pediatric surgeon should intervene very early to manage hypospadias successfully.

Hypospadias surgery performed on time will ensure the urine works properly, the penis grows normally, and the appearance of the penis is improved. Delaying treatment can lead to complications such as abnormal urination, psychological problems, or functional problems in the future.

Consulting with the best paediatrician surgeon in Faridabad allows for a precise diagnosis, optimal timing of surgery, and personalised care based on the child's individual circumstances. If intervention is provided early, the long-term outcome will be much better, and the overall quality of life will be improved.

Prevention & Lifestyle Considerations

Hypospadias is not preventable in all cases; however, if precautions are taken during pregnancy and early in the newborn’s life, the chance of developing hypospadias may be decreased and will aid in identifying and treating the condition in a timely manner. The following recommendations can help decrease the likelihood of hypospadias occurring and/or provide an early diagnosis so appropriate treatment can be given:

• Proper prenatal care during pregnancy: Appropriate fetal growth and development can occur through routine prenatal care, a balanced diet, and medical supervision during the mother’s pregnancy, which will decrease risk factors for congenital conditions.

• Minimising exposure to harmful chemicals: Avoiding exposure to pesticides, endocrine-disrupting chemicals, and other harmful substances during pregnancy can potentially reduce the risk of developmental defects.

• Routine antenatal check-ups: Routine antenatal check-ups will allow monitoring of the fetus’s growth and detection of any abnormalities early on, thus facilitating appropriate medical advice and intervention when necessary.

• Early newborn screening: An examination at the time of birth will identify hypospadias early, which will allow for timely referral and appropriate surgical planning for correction.

• Timely referral to pediatric medical specialists: When children are assessed by pediatric urologists and/or surgeons at the earliest possible time, they will be able to provide an accurate diagnosis and to develop an appropriate treatment plan, which will lead to optimal outcomes for the child.

Pre–Post Treatment Care

Pre-Treatment

• Early consultation with a paediatric surgeon
• Clinical evaluation and classification
• Planning of surgical approach

Post-Treatment

• Wound care and hygiene maintenance
• Monitoring urine flow
• Follow-up visits with paediatric surgeon
• Observation for complications such as infection or leakage