Hypospadias repair surgery is a very delicate and demanding surgery. We have realized that hypospadias repair procedure is not a surgery which can be done casually or as one of the many surgeries which a surgeon does. Best results of hypospadias surgeries are seen only when the surgeon dedicates his time and energy in pursuing the art and science of hypospadiology. Results keep on improving day by day and year by year. With more than 5000 hypospadias repairs done over last 16 years, Hypospadias Foundation at MITR Hospital, Navi Mumbai, India provides the best results in hypospadias surgeries. Children have travelled from all over India and other countries such as Nigeria, Greece, Bangladesh, Iraq, UAE to get treated under Dr Singal’s care for hypospadias.
To get the best outcome in hypospadias, it requires a big team effort which includes hypospadias surgeons, assistants, well trained OT staff and post-surgery caring staff.
Along with post operative care which includes post operative dressing, wound care, medicines etc we have also found that hyperbaric oxygen therapy is beneficial in hypospadias. Here is a guide regarding hyperbaric oxygen therapy in hypospadias.
1.What is hyperbaric oxygen therapy?
Hyperbaric oxygen therapy (HBOT) is a medical treatment that involves breathing pure oxygen in a pressurized chamber. The increased pressure allows more oxygen to dissolve in the blood which is then delivered to the tissues. When tissues are injured or under stress, they need adequate supply of oxygen to function. This HBOT ensures extra oxygen supply to the tissues and this temporary increase is maintained even after the sessions are done.
Picture shows Hyperbaric oxygen therapy(HBOT) chamber
2.How does hyperbaric therapy help in hypospadias healing?
In HBOT, the air pressure is increased 2-3 times higher than the normal air pressure. This causes the lungs to gather more oxygen. This extra oxygen stimulates the growth factor and stem cells to promote healing and fights bacteria after hypospadias surgery.
3.What type of hypospadias repairs requires post-surgery hyperbaric oxygen?
In hypospadias repair, HBOT is required in following cases:
a.Redo hypospadias (hypospadias after previous multiple failed attempts)- after multiple previous surgeries, the vascularity of the penile tissues may be poor. We can expect slow healing in these cases during future repairs. HBOT in these cases will ensure good oxygen supply and will promote growth factors to aid in formation of new tissues to promote healing.
bAdult hypospadias: The cell turnover rate in adults is slower than children. Post surgery there is high risk of infection in adults in turn leading to pus formation and wound dehiscence. HBOT ensures increased oxygen delivery to these tissues which in turn will help in tissue regeneration, infection prevention and better healing in the post operative period.
4.What is the typical schedule and cost of hyperbaric oxygen therapy?
Typical schedule for HBOT is 7 sessions in the post operative period starting from 24-48 hours after surgery. These 7 sessiares will cause temporary rise in oxygen levels which is maintained even after the sessions are complete. It’s a 1-hour session per day. The chamber is compressed to 2.0 atmospheric pressure. 2-3 air breaks are given in each session (oxygen level is decreased from 100% to 21% for 5 mins in the 1 hour period). If a child is undergoing HBOT then a parent along with the child will be allowed to sit in the pressurized chamber. Continuous monitoring is done during the session. The average cost of HBOT session in Kharghar, Navi mumbai is 3500 INR or around 40 USD per session.
At hypospadias foundation, more than 50% of the cases are the ones with previous failed surgeries. Every year we perform more than 250 hypospadias surgeries and more than 20% of these are adults suffering from hypospadias. All these patients come to us with a lot of hope and trust us that we will treat their hypospadias. Our main aim of starting HBOT was achieve good results and decrease the risk of hypospadias complications. With HBOT we have been able to achieve it and strive to do better in the future. Over the last few years, Dr A.K.Singal, rated as the best hypospadias surgeon in India, has an expertise and a special interest in managing failed hypospadias cases. He along with Dr Shenoy have standardized the hypospadias management protocol so efficiently that success rates have increased significantly.