Hypospadias: Concerns and Treatment Options for Your Child - Surgery

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Hypospadias is a congenital condition in which the opening of the urethra is not located at the tip of the penis but instead is found on the underside. This condition can vary in severity, and in your case, it appears to be classified as mild. The fact that your child has undergone two surgical procedures but continues to experience issues such as urinary leakage and a narrowing of the urethral opening is understandably concerning for both you and your wife.

The surgical correction of hypospadias is typically performed to create a functional and cosmetically acceptable urethral opening. The success rate for these surgeries is generally high, often cited at over 90%, but complications can occur. These complications may include stricture (narrowing of the urethra), fistula (an abnormal connection between the urethra and the skin), or recurrent hypospadias. The fact that your child has had two surgeries and is still experiencing problems may indicate that further evaluation and possibly additional surgical intervention may be necessary.

When considering a change in medical facilities, such as moving from Kaohsiung Chang Gung Memorial Hospital to Linkou Chang Gung Memorial Hospital, it is essential to ensure that the new facility has a pediatric urologist with experience in treating hypospadias. You may want to inquire about the specific expertise of the surgeons at Linkou and their approach to managing complications associated with hypospadias repair.

Regarding the issue of a narrowed urethral opening, there are several potential management strategies. If the urethral opening is too small, the surgeon may consider a procedure to widen it, which could involve techniques such as urethral dilation or a more extensive surgical reconstruction. In some cases, a stent or catheter may be placed temporarily to help maintain the opening during the healing process.

It is also crucial to have open communication with your child's healthcare team. Discuss your concerns about the current state of your child's condition and the outcomes of previous surgeries. A thorough examination and possibly imaging studies may be necessary to assess the anatomy and function of the urethra more accurately.

In summary, while hypospadias can be successfully treated, complications can arise that may require further intervention. Transitioning to a facility with specialized expertise in pediatric urology may provide you with more options and a better understanding of your child's condition. Ensure that you discuss all your concerns with the new medical team and consider seeking a second opinion if necessary. Your child's health and well-being are paramount, and finding the right care is essential for addressing the ongoing issues related to hypospadias.