Hypospadias is the most common urological birth defect occurring in upto 1/150 newborn boys, which means almost 75,000 children are born with hypospadias every year in India. While most of the cases are not hereditary or genetic, 6-8% of hypospadias cases have a family history of hypospadias or associated genetic disorders. In the current era and in cities, most of these children are referred to pediatric urologists or hypospadias surgeons in early childhood and receive timely treatment for hypospadias. This was not true 20 years back. Hence, there are a large number of adults living with hypospadias across the world either with unrepaired primary adult hypospadias or some who have failed hypospadias surgery in childhood. In India alone, there are an estimated 5 lakh adults who have either not received hypospadias treatment or have failed hypospadias surgery in their earlier years and their families or they themselves have given up.
It is possible to get very good results in adult hypospadias repair, but every adult undergoing hypospadias treatment must understand a few facts which make hypospadias surgery and post-surgery course a little different in an adult.
Hypospadias repair surgery in adults- Differences from surgery in children:
- Longer healing time than children: In expert hands, overall success rates of hypospadias treatment and surgery in adults remain good and comparable to hypospadias repair in children, though the healing of penis takes longer. Post adult hypospadias surgery, the person can can start passing urine normally in 2-3 weeks, but it may take upto 2-3 months for the penis skin to heal fully.
- Longer time for indwelling urine catheter: We like to keep catheter inside for 14-21 days for distal hypospadias repair in adults and 21 days for severe hypospadias repair in adults. This is in contrast to children where most of the catheters are removed in 7-10 days.
- Higher risk of infections: Since there is hair growth in penile area and more sweating in adults, the chances of skin infections at hypospadias surgery site is higher in adults. Hence, we like to give injectable antibiotics for 3 days in adults and oral antibiotics for 21 days.
- Pain after surgery: As adults have night-time erections during a certain phase of the sleep, there may be episodes of severe pain during healing phase in first one month. Hence, we give medicines to decrease the frequency of erections for 4-6 weeks and stronger pain killers in adults.
- Abstinence from sex: We advise abstinence from sex and masturbation for almost 3 months after hypospadias surgery in adults.
- Off from work: Since most of the adults are in a job or business, it is important to take atleast 4 weeks off from travelling to work after adult hypospadias surgery. You can work from home within 3-4 days of surgery.
- Uroflowmetery: We recommend performing a test called uroflowmetry to check the speed of urine passage at 3 months and one year of surgery to make sure that the new passage is of good calibre.
- Psychological help: Some of the adults may have lot of anxiety or stress due to hypospadias or its treatment. We advise a stress and anxiety relief counselling therapy sessions before surgery. This can help the person cope with the stress of treatment and repair and look forward to the surgery in a positive way.
Though there are challenges in treating adults with hypospadias, but with diligence and dedication very good results can be achieved at centres of excellence in Hypospadias treatment. A good counselling, a thorough OPD consultation are a must before embarking on the surgery to ensure that the adults with hypospadias understand the treatment, results and long-term outcomes. This also helps in setting the expectations right after Hypospadias surgery.
Adult Hypospadias Surgery Case gallery:
- Case 1: Adult Redo Hypospadias Using Flap Repair After A Failed Surgery In Childhood
- Case 2: Adult Redo Hypospadias Repair By Single Stage Oral Mucosa Graft Inlay Urethroplasty
- Case 3: Single Stage Hypospadias Repair In An Adult After Adulthood Diagnosis Of Hypospadias
- Case 4: Single Stage Primary Hypospadias Repair Surgery In An Adult
Watch video of Dr Singal & Dr Shenoy about adult hypospadias surgery
Other resources for Adult Hypospadias
- Pre surgery care for Adult Hypospadias
- Post surgery care for Adult Hypospadias
About Hypospadias Foundation
Hypospadias foundation is dedicated to care of children and adults suffering from Hypospadias. Since Nov 2008, more than 5000 children and adults have been treated for hypospadias at Navi Mumbai India. We treat more than 250 cases every year and of these 20% are adults with either primary or failed hypospadias. We get adult hypospadias cases from all over India and more than 25 countries who come to Navi Mumbai for state of art treatment, surgery for adult hypospadias and best results for adult hypospadias surgery. The unique teamwork between a pediatric and adult urologist allows adults with hypospadias to gain the best treatment of adult hypospadias.