Understanding surgery available to correct hypospadias

9th February 2014

 

Plastic surgeons deal with a variety of conditions in patients of all ages and excel at very delicate and precise repair or reconstruction of parts of the body. Hypospadias is a common birth defect in newly born boys which affects the penis and prevents them from urinating properly, as well as looking abnormal. Due to the personal nature of the matter, there is little information about this condition as it’s not often discussed by parents and patients. However, BAPRAS hopes to raise awareness of this condition, as well as provide better support for patients and parents.

Although hypospadias affects as many as one in 300 new born boys, there is little public awareness or recognition due to the sensitive nature of the issue. Yet parents feel that there should be better standards of information to help them understand the abnormality, as well as providing reassurance that it is common and can be treated. It does not affect fertility and it is a random condition with no known exact cause. It may be inherited but its development is understood to be related to many factors.

Normally when the boy is born the midwife and paediatrician check for any abnormalities. If hypospadias is diagnosed, the parents are referred to the local surgeon. In the UK the surgeon who treats this condition may be a urologist or plastic surgeon trained in this type of highly specialised work. The surgeon and nurses will treat any case sensitively and explain that it is correctable. Parents will be given a comprehensive information sheet which we can provide upon request.

Corrective surgery is usually performed when children are either 12 months or three years old. Around half of cases are treated by plastic surgeons, but they are also treated by urologists and paediatric surgeons. The exact type of surgery will be explained by the surgeon. The procedure itself is complex; there have been numerous techniques and treatment methods have been used successfully. BAPRAS hope to develop consistency and ensure high standards for the benefit of patients. The development of techniques has got better and better over the years and significant improvements are being made.
There needs to be a greater effort to encourage dialogue and awareness amongst parents, and to remove the ‘taboo’ nature of the problem, along with better public facing information in the form of leaflets and guidance. Our specialist group is also promoting teaching for future generation of surgeons and to deal with complex cases. Hypospadias is in the curriculum for trainee plastic surgeons in the UK and knowledge is tested in the final specialist exam. We hope to provide more opportunities for junior surgeons to get training and develop their skills and interest in this important field.

The fact that it is a technically difficult procedure makes it especially important that more training centres are provided so that consultants who perform this surgery regularly can pass on their skills. A thorough understanding and training in microsurgical skills, paediatric surgery skills and paediatric support is essential.

There is a real drive amongst plastic surgeons to make this a widely publicised issue to help patients get information. We also want to develop training in this area of surgical expertise. This is one of the reasons why BAPRAS has dedicated a special interest group to the topic.

Rajan Uppal

More about the BAPRAS special interest group for hypospadias 
View our patient information guide on hypospadias

 

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