Hypospadias Surgery: Problem or not?
- dr Nikola Stanojević
- Apr 20
- 5 min read
Hypospadias is an anomaly that can only be treated surgically.
Most parents are surprised to hear that a congenital penile defect, hypospadias, is almost the most common congenital anomaly. It affects one in 150 boys and is more common than cleft lip, Down syndrome or spina bifida. It can occur in several forms, from the form where the external opening of the spinal canal (urethra) is normally placed on the tip of the penis, to the form where the opening of the urethra is located on the perineum towards the anus.
Types of hypospadias:
- glandular hypospadias
- coronal hypospadias
- distal hypospadias
- hypospadias without hypospadias
- penoscrotal hypospadias
- scrotal hypopaedia
- female hypospadias
Is hypospadias surgery an intractable problem?
Hypospadias is an anomaly that can only be treated surgically. There are no easy or difficult forms of hypospadias to solve, each form of hypospadias requires a complicated surgical intervention of detailed correction of the anatomy of the penis.
Despite the frequency of the anomaly, surgical treatment of hypospadias in standard urological practice has a high failure rate. Doctors - surgeons generally warn the parents of a child with hypospadias that at least 3 or 4 operations are needed to solve the problem. Such promises are based on previous failed attempts at surgical treatment of hypospadias. At the global level, about 50% of hypospadias operations are complicated by the need for a new operation, and it often happens that parents bring a child who has been operated unsuccessfully more than 5 times for treatment.
Many surgeons associate the reconstruction of hypospadias with the repair of a displaced opening of the urinary canal (lower placed urethra), but they often overlook that a properly performed correction of hypospadias must ensure a completely natural appearance and anatomy of the genitals: straightened penis, urethra brought to the tip of the glans, aesthetically reconstructed glans of the penis, reconstructed skin of the penis and skin of the scrotum.
The high failure rate of hypospadias repair makes the whole process very difficult, but a well-trained surgeon can almost always avoid a bad outcome of the operation and correct the original problem. In addition to great experience and the number of successfully performed operations, the doctor must also possess great creativity, an almost artistic ability to create and originality in order to successfully perform hypospadias surgery.
Be careful who you entrust your son with for hypospadias treatment
Ask about the best urogenital reconstructive surgeon for your young child. Do not rely only on the nearest or most convenient doctor who is ready to try bad techniques on your child again after failure. Spare your son from repeated physical and permanent mental trauma.
Our approach to hypospadias surgery in urology is not experimental. We continue the practice of the world's most significant school of urogenital surgery, which was conceived by academician prof. Dr. Sava Perović. Dr. Nikola Stanojević and his team of reconstructive surgeons assisted, collaborated and studied with prof. Dr. Sava Perović for many years. The specificity of the teaching of prof. Dr. Sava Perović in the reconstruction of hypospadias means successful treatment of hypospadias with only one operation , which is often referred to as "Perovic Hipospadias Repair".
Patients receive aesthetically natural, fully functional, permanent results from surgical treatment of hypospadias. The degree of complications when using the techniques of Prof. Dr. Sava Perović's case of hypospadias is extremely small.
In particularly complex and challenging cases, it may be necessary to plan two surgeries for hypospadias repair, with 4 to 6 months between surgeries. The assessment of whether two operations are necessary is given during the first examination by Dr. Nikola Stanojević.
The course of surgery and postoperative recovery
Hypospadias does not threaten the normal growth and development of the child, and is not operated on until the child reaches a certain age. Most often, the operation is planned when the boy turns 18 months old.
There is no upper age limit for hypospadias reconstruction.
The surgical intervention itself lasts about two hours. The child stays in the hospital for one day. In the postoperative course, daily close contact with the doctor is provided for regular dressings. Usually, two weeks after the operation, all bandages and stents are removed, and then the child begins to urinate naturally.
In his practice, Dr. Nikola Stanojević treats his young patients very carefully: he never ties them up, nor forcibly separates them from their parents, as is often done in many countries. The child enters anesthesia while still in the hospital suite. Parents, except inside the operating room, are constantly with their child in the hospital. Such an approach reduces emotional trauma for the whole family.
All these "little things" contribute to our extremely high success rate in the treatment of all types of hypospadias - whether severe, mild or previously unsuccessfully operated on.
Once again, we must emphasize the importance of choosing the right surgeon to entrust your child with. If you are at all hesitant, do not submit your child to surgery, solving hypospadias is not an emergency.
Treatment of hypospadias in adults
No matter how old you are, whether you've never had surgery or you've had surgery without success - it's not too late to get your hypospadias fixed so you can continue to enjoy a good quality of life.
We will help you
Publications
Corporal penile curvature (CPC) and surgical complications in hypospadias repairs: Associations and outcomes - European Urology Supplements 03/2019; M. Bandini, N. Stanojevic , V. Pesic, A. Briganti, R. Djinovic, A. Salonia, F. Montorsi
Hypospadias complexity score (HCS): A new tool for predicting operating time and complications in hypospadias surgery - European Urology Supplements 03/2019; M. Bandini, S. Sekulovic, N. Stanojevic , V. Pesic, A. Briganti, R. Djinovic, A. Salonia, F. Montorsi
Corporeal penile curvature (CPC) and surgical complications in hypospadias repairs: Associations and outcomes - European Urology Supplements 03/2019; M. Bandini, N. Stanojevic , V. Pesic, A. Briganti, R. Djinovic, A. Salonia, F. Montorsi
Hypospadias complexity score (HCS): A new tool for predicting operating time and complications in hypospadias surgery - European Urology Supplements 03/2019; M. Bandini, S. Sekulovic, N. Stanojevic , V. Pesic, A. Briganti, R. Djinovic, A. Salonia, F. Montorsi
Real prevalence and severity of penile curvature in different types of hypospadias - European Urology Supplements 03/2019; S. Sekulović, M. Bandini, B. Spiridonescu, N. Stanojevic , M. Slavkovic, V. Pesic, R. Djinovic, F. Montorsi
Prevalence and surgical management of pubic hypertrophy in hypospadias patients: Results from a high-volume surgeon - European Urology Supplements 03/2019; M. Bandini, S. Sekulović, N. Stanojevic , V. Pesic, M. Slavkovic, R. Djinovic, A. Briganti, A. Salonia, F. Montorsi
Treatment of penile urethral stricture in patients with failed hypospadias repair using buccal mucosa grafting - Journal of Sexual Medicine 04/2017; N. Stanojevic , A. Ruffo, G. Di Lauro, L. Romis, G. Romeo, F. Iacono
Redo hypospadias repair. Surgical problems faced in 223 adult patients - The Journal of Urology 04/2011; Rados Djinovic, Guido Barbagli, Salvatore Sansalone, Nikola Stanojevic , Giuseppe Romano, Sasa Tomovic
Failed Hypospadias Repair – Retrospective Analysis in 223 Patients - Journal of Pediatric Urology 04/2010; Sava V Perovic, Nikola Stanojevic, Marko Milosavljevic, Rados Djinovic
