Urinary Dysfunction: Concerns About Hypospadias Treatment

Q: Urinary Dysfunction: Concerns About Hypospadias Treatment

Hello： According to the previous regulations (it is uncertain if there have been changes this year), Article 103 states that individuals with urethral lacerations or strictures who have undergone surgical treatment for more than six months and still experience urinary dysfunction

Individuals with urinary dysfunction?

Hello Doctor: I would like to ask if the management of hypospadias is complicated.
Additionally, according to the announcement from the Ministry of the Interior, individuals with urethral defects or strictures who have undergone surgical treatment for more than six months and still experience urinary dysfunction are exempt from military service.
If I have urinary difficulties without having undergone surgery, what would be the classification? Thank you.

yoto, 20~29 year old female. Ask Date: 2023/08/07

Dr. Du Shixi reply Urology

Hello: According to the previous regulations (it is uncertain if there have been changes this year), Article 103 states that individuals with urethral lacerations or strictures who have undergone surgical treatment for more than six months and still experience urinary dysfunction are included.
Urethral lacerations or strictures must be accompanied by reports of urethrography and urodynamic studies.
The dysfunction must be assessed through a uroflowmetry test, where the single voided volume must exceed 150 milliliters, with a maximum flow rate of less than 15 milliliters per second and an average flow rate of less than 10 milliliters per second.
The urethral lacerations and strictures mentioned are likely referring to types that require surgery from childhood; if surgery is not required, they should not fall under this regulation and generally should not have urinary dysfunction.
If you are experiencing urinary dysfunction, you should seek examination at a major hospital, where urethrography and urodynamic or uroflowmetry tests can be performed to determine if there is any obstruction, as these tests may not be available at general hospitals.
Wishing you good health.

Reply Date: 2023/08/07

More Info

Hypospadias is a congenital condition in which the urethra does not open at the tip of the penis but rather on the underside. This condition can lead to various urinary dysfunctions, including difficulties with urination, abnormal urine stream, and potential complications during sexual function later in life. The treatment for hypospadias typically involves surgical correction, which is generally performed in early childhood, often between 6 months and 18 months of age.
The complexity of the surgical procedure can vary significantly depending on the severity of the hypospadias. In mild cases, the surgery may be relatively straightforward, involving the repositioning of the urethral opening. In more severe cases, where there may be associated conditions such as chordee (curvature of the penis), the surgery can be more complicated and may require multiple stages.
Post-surgery, most children experience significant improvement in urinary function, but there can be complications such as strictures (narrowing of the urethra), fistulas (abnormal connections), or recurrent hypospadias. Regular follow-up with a pediatric urologist is essential to monitor for these potential issues.

Regarding your concern about the implications of urinary dysfunction and military service, the regulations can vary by country. In many places, if a person has not undergone surgical correction for hypospadias and experiences urinary dysfunction, they may be classified as unfit for military service. The specific criteria can depend on the severity of the dysfunction and how it impacts daily life.
If you have not had surgery and are experiencing urinary difficulties, it is crucial to document these issues with a healthcare provider. They can provide a thorough assessment and potentially recommend further evaluation or treatment options.
In terms of positioning for urination, individuals with hypospadias may find that certain positions can help facilitate urination. For example, sitting down may provide more control over the urine stream compared to standing, especially if the urethral opening is located significantly below the tip of the penis.
In conclusion, while the surgical treatment of hypospadias can be complex, it is generally effective in improving urinary function. If you are experiencing urinary dysfunction and have not undergone surgery, it is advisable to consult with a urologist who can provide a personalized assessment and discuss potential treatment options. Additionally, understanding the implications of your condition regarding military service is essential, and a healthcare provider can assist in navigating this process.

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