hypospadias treatment in India Archives

July 07 2015

Single stage hypospadias repair surgery video for a child with failed hypospadias: Nagpur to Vellore to Navi Mumbai, India

Like every other surgery, hypospadias correction surgery has its own risks, complications and failures. Inspite of the best intentions and efforts of the parents and the treating hypospadias surgeon, still the results may be sub-optimal after the first surgery. Though at the end of hypospadias surgery in OT it may seem that the surgery has gone very well, sometimes there may be minor complications which necessitate a second surgery for hypospadias in some children. The rate of second surgery for a complication or failure of first hypospadias surgery decrease with the expertise and experience of the hypospadias surgeon but it is never zero and that is an important thing for the parents and families to understand.

When the first surgery for hypospadias fails, parents get very disturbed and start looking for more information on why it happened and the solutions and second opinion for hypospadias to help fix the problem. Most of the times, the primary surgeon may be the best person to solve the problem but sometimes the complication may be severe and in such cases the patient should be referred to a centre of excellence in hypospadias surgery.

While minor problems like fistula or cosmetic issues can be treated easily with as second minor surgery- major complications of hypospadias surgery such as urethral breakdown, dehiscence, urethral diverticulum or stricture may require more complicated or even a staged repair with grafts. Hence, the dictum- that first surgery for hypospadias is the best surgery- further surgery if the first one fails is always more difficult and challenging.

At Hypospadias Foundation, we regularly receive kids and adults from all over India and other countries who have had a failed hypospadias surgery elsewhere. Families request for a second opinion for the hypospadias treatment and we advise them comprehensively. Some of these cases really benefit from the specialist care offered by a dedicated hypospadias team.

Case Story

Master A.G., a 3 years old boy, resident of Nagpur, underwent a surgery for a proximal penile hypospadias surgery at a hospital in Vellore. Unfortunately, the healing was not optimal and the whole repair had a breakdown. After 6 months of previous surgery, the family wrote to us and visited us at our centre in Kharghar, Navi Mumbai. On examination, the child has proximal penile meatus with mild chordee. There was a remnant of foreskin (prepuce) on the underside of penis. There was no foreskin left on the topside of penis. We explained to the parents that this may require a two stage repair but we will try out best to make a flap from the residual foreskin and do the surgery in one stage.

Finally after pre-surgery tests and fitness assessments, we took the child for redo-hypospadias surgery. We could make a nice onlay flap out of the foreskin remnant by carefully dissecting the blood supply and preserving the supply to this flap skin. The flap was used to make the new urethra in one stage as it can be seen in the video below. The surgery took about 3 hours and the child was allowed feeds four hours after surgery. The dressing was removed after 7 days and catheter after 10 days. The hypospadias site healed very well and the child was examined again after 1 month. He was passing urine well in a single stream from the tip of penis. Now, 6 months after hypospadias repair, A.G. continues to do well and his parents are very happy and we are also overjoyed to achieve a good result in this challenging failed hypospadias case. The detailed hypospadias surgery video can be watched by clicking below. Besides the story mentioned here, the video below shows another child story from Raipur, Chattisgarh where the first surgery resulted in a penile torsion and a large fistula. The child underwent a successful single stage surgery at Hypospadias Foundation:

Watch Video of Failed Hypospadias surgery by Dr A.K.Singal

If you or your loved one has hypospadias and wish to seek an opinion, please write to us at hypospadiasfoundationindia@gmail.com or contact Dr Rajkumar- Coordinator at +91-9821261448 between 10 am-5pm India Time.

You can also fill up this contact form: Contact Hypospadias Foundation

or come to MITR Hospital in person after taking an appointment by sending an email at frontdesk@mitrhospital.com or calling up at +91-22-27743558/ 4229 or +91-9324180553

Watch Video of proximal penile hypospadias correction by Dr A.K.Singal

Watch Video of scrotal hypospadias repair by Dr A.K.Singal

Watch video of Distal penile hypospadias repair by Dr A.K.Singal

July 07 2015

A little boy from Bangladesh takes a little bit of India with him: Successful Distal Penile Hypospadias Repair Surgery in Navi Mumbai

We are privileged to care for children from across the world who come with their parents to our Hypospadias centre in Navi Mumbai, India looking for the best in Hypospadias surgery and treatment. The love and affection which we give to the kids is a mirror image of the trust and faith which family puts in us. It is the simple rule of medical care and cure.

Happy kids= happy parents = good results= happy surgeon who sleeps well. Our nurses and junior doctors almost adopt the kid as one of theirs and then play with the kid during recovery time and we see that with such a personalized care the kids recover after hypospadias surgery in no time.

Somebody said it aptly, “When you are happy the time flies very fast”. Hence, if everyone remains happy and in high spirits after a hypospadias surgery, time just disappears. Long journey to India and time spent here seems worthwhile.

The Email from Dhaka, Bangladesh:

Dear Sir,

Here is our testimony. As you know we are from Dhaka city in Bangladesh and when our son, baby Satyaki Sarkar, was born, he had a problem which the doctors named distal penile hypospadias. So when doctor told us about this problem we were very worried. We didn’t know what to do because we never heard the name of such type of problem. I searched in internet about the problem for best doctor for hypospadias. After searching internet we got the address of Dr. Arbinder Singal, Hypospadias specialist surgeon and Hypospadias Foundation in Navi Mumbai, India. We also watched the video of hypospadias repair surgery which they had uploaded related to surgery about hypospadias of a baby. We also studied the articles of Dr. Singal and others hypospadias surgeons around the world. After that we finally decided to do the hypospadias repair surgery in Navi Mumbai India, at MITR Hospital & Hypospadias foundation. We contacted with the authority of Hypospadias foundation for getting appointment. Ms. Emily Paul and Dr. Rajkumar Gupta arranged appointment for us in a cordial way.

Now it was time for hypospadias surgery. We met with Dr. Singal on 21st March. He appointed us on 23rd March for operation. We were so tensed about Satyaki’s operation. But Dr. Singal and his team were so cooperative that we forgot about all tensions and focused only on Satyaki’s operation. At last, on 23rd March, 2015, the hypospadias operation was done successfully without any problem. After having surgery we stayed in the hospital for one day and the next day they discharged us. After having surgery we felt that we came in the right place because my baby had no surgical pains. He recovered so quickly that we couldn’t imagine. We realized that best results are possible after hypospadias surgery.
We would like to specially mention about the nurses and staffs of hypospadias foundation. They were so cooperative, and cordial. They can manage the babies with hypospadias after surgery in a very caring and professional way.
Now my little boy is completely recovered and doing well without any problem. You may post the picture of my baby and us which you have to us. Because we think that this may help to realize the families that hypospadias problem may be solved through proper surgery. We also think that through our message and picture many families who are suffering from this problem will get new aspirations and hope.
At last we again want to give thanks to Dr. Singal and his team for doing this surgery in an excellent way. We wish success of this foundation in every step of its life.
With best regards

Sanjeev Kumar Sarkar
Father of Satyaki Sarkar
Dhaka, Bangladesh.

Satyaki Sarkar after successful hypospadias surgery with his family and Dr Singal

Case Details: Master Satyaki had a coronal hypospadias, a variety of distal penile hypospadias. He did not have any chordee and his urethral plate was good quality. Hence, we elected to perform a TIP (Tubularised Incised Plate urethroplasty, also called Snodgrass repair). The surgery was completed in one hour’s time and Satyaki was allowed feeds two hours after surgery. He recovered well from anesthesia and surgery and was planned for discharge the next day. In the usual course of family living nearby, we could have sent him home the same day also but since the family had travelled all the way from Bangladesh we kept them in hospital for overnight observation and then they shifted to a nearby hotel. Hypospadias dressing and catheter was removed 5 days after surgery and a final examination done 10 days later showed everything to be well healed and Satyaki was passing urine very well from his new opening at the tip of penis. Now at three months after surgery, Satyaki continues to do well and surgical team is delighted with the outcome of surgery.

While most of families may be little concerned about sharing their personal details etc, Mr Sarkar was very gracious and himself offered to share pictures and details to lend authenticity to the story. He felt this will encourage the parents to think positively about hypospadias treatment in their children. Our endeavor at Hypospadias Foundation of providing good personal and surgical care to children stands fulfilled when we get testimonial and review emails like this one.

About Hypospadias Foundation:

Hypospadias Foundation is a centre of excellence for treatment of children and adults having hypospadias. The centre is located within MITR Hospital at Kharghar, Navi Mumbai India and is the best hospital for treatment and care for patients with hypospadias and associated problems including DSD. The team is led by Dr A.K.Singal, a renowned Pediatric urologist surgeon and an excellent hypospadias surgeon. He is supported by Dr Manish Dubey who helped Dr Singal start Hypospadias Foundation and is himself a renowned Urologist. Every year more than 200 kids and adults travel to Navi Mumbai for care and treatment of Hypospadias. If you wish to contact us, you can write to us at hypospadiasfoundationindia@gmail.com or call Dr Rajkumar, Coordinator for Hypospadias Foundation at +919821261448 between 10am-5pm, India time.

You can also click here and fill up the contact form and we will answer your query as soon as possible

Watch Video of Distal penile Hypospadias repair procedure by Dr A.K.Singal

Watch Video of proximal penile hypospadias procedure by Dr A.K.Singal

Watch Video of severe scrotal hypospadias repair by Dr A.K.Singal

March 03 2015

In search for a cure for Hypospadias: From Lucknow to Navi Mumbai, India

Hypospadias remains the most common urological anomaly in boys and more than 1 lakh kids are born in India every year with Hypospadias. Majority of these are mild variety like glanular, coronal, distal penile or midpenile hypospadias. Less than 15% of all hypospadias are moderate to severe variety of hypospadias like proximal penile, penoscrotal or scrotal hypospadias. While very mild hypospadias like glanular or coronal without chordee may be left alone without surgery, all other types of hypospadias or those with chordee require hypospadias correction treatment.

There are more than 100 different types of hypospadias surgery techniques described in medical literature attesting to the fact that none of the techniques are perfect or suitable for all types of hypospadias. The hypospadias specialist surgeon needs to be well acquainted with anatomy and various techniques to decide the type of surgery needed in a particular hypospadias case. Subtle variations in anatomy decide the type of technique needed. Hence the decision for each hypospadias is very individualized.

The common techniques in use for primary hypospadias are TIP urethroplasty (Snodgrass repair), Mathieu repair, Onlay Island flap urethroplasty, Prepucial tube and staged Bracka’s urethroplasty. Each technique of hypospadias surgery has its own advantages and disadvantages and case selection becomes very important.

Case: Boy from Lucknow

Master A.C. was born with proximal penile hypospadias in Lucknow. He was advised surgery after one year of age by the doctors in Lucknow. They consulted various surgeons in Lucknow and Delhi but were not satisfied by the approach. Finally, the boy’s uncle who was a scientist in CSIR sent an email to Hypospadias Foundation with all records and pictures asking for an opinion. We advised a clinical examination and a single stage surgery. The family flew to Mumbai and saw us in MITR Hospital, Kharghar where Hypospadias Foundation is located. The penis size for Master A.C. was very small with a stretched penile length of 2 cm and Glans diameter of 11mm. We advised two injections of Testosterone (male hormone) to induce growth of penis at one month interval. After one month of second injection, the glans size increased to 15.5 mm and penis length to 29mm. At this time, we planned a hypospadias correction surgery. A.C. was admitted the morning of surgery and a single stage urethroplasty was done using Onlay Island Flap technique for which Dr Singal is very renowned. The surgery took 90 minutes and the boy was discharged the next morning after hypospadias surgery. The dressing was removed after 5 days and catheter was removed after 10 days. A.C. passed urine well and at one month follow-up was passing urine in a good stream without any issues. The penis has healed very well with an excellent cosmetic result. The parents were overjoyed and sent an email of thanks after one month from Lucknow. Further follow-ups will be via email and phone calls. Patients from across the globe follow-up with us using electronic medium such as email, whats app and skype.

Dr Singal with Family from Lucknow

Testosterone (hormone) injection before Hypospadias surgery

In some cases of hypospadias the penile size may be small and the head of penis (glans) may be very tiny. In such cases it is difficult to repair the hypospadias adequately. We advise testosterone injections in dose of 25mg intramuscular injections two months and one month before surgery. The testosterone injections help in two ways: Increasing the size of penis and glans; secondly the blood supply (vascularity) of the foreskin increases which helps in making a good flap in severe hypospadias. Two doses of testosterone injections do not have any short term or long term side effects on body growth etc. Part of the effect of testosterone on penile growth is reversible but part increase in size of penis is permanent. For us at Hypospadias foundation, we give Testosterone injections for babies where the penis size is less than 25mm or the glans diameter is less than 13-14mm.

Onlay Island flap urethroplasty

Onlay island flap urethroplasty is a type of hypospadias repair surgery where a flap is made from foreskin on the top of penis (dorsal prepuce) and brought on underside of penis. This flap is based on a robust blood supply from dartos tissue of the foreskin (see the video below). Onlay island flap urethroplasty is reserved for severe hypospadias or where the TIP repair is not suitable and the chordee is not very severe. In hands of expert hypospadias surgeons, Onlay Island flap urethroplasty offers best results in repair of severe hypospadias. Dr A.K.Singal is one of the best hypospadias surgeon specialists in India for such surgeries. Dr Singal has been invited at various national and international conferences to showcase his surgical technique (see video below). Every year more than 200 children and adults with primary or failed hypospadias are operated under his team’s care in Navi Mumbai, India.

If your child has a hypospadias and you wish to get in touch with Dr Singal for treatment, you can fill up the contact form below or you can see him at one of his hypospadias clinics in Navi Mumbai or Mumbai. You can also call up Dr Rajkumar, Co-ordinator for Hypospadias Foundation at +91-9821261448 between 9am-6pm to discuss any queries.

Dr Singal’s clinics and Timings

Contact form for Dr Singal & Hypospadias Foundation

See Video of Proximal penile hypospadias repair using Onlay Island flap technique- by Dr A.K.Singal

See Scrotal Hypospadias repair using Onlay Island flap urethroplasty- by Dr A.K.Singal

Contact Form for Hypospadias Foundation

Please fill all clinical details and upload pictures and clinical summaries (if available)

December 12 2014

Letter from Afghanistan: 8 month old child undergoes successful hypospadias repair surgery at Hypospadias Foundation in Navi Mumbai, India

Hello Dr A.K.Singal,

My feedback from my baby’s operation at Hypospadias Foundation & MITR hospital in Navi Mumbai, Kharghar, sector 21:

When I was told by my baby’s doctor at the time of birth that he had hypospadias, we were very worried about it as it was the first time I had heard such case. Then I started searching about treatment and could not find any specialist locally in Afghanistan. Then we searched for a hypospadias specialist in India and could find the best pediatric urologist surgeon in Mumbai called Dr. A. K Singal in MITR hospital in Navi Mumbai although, I searched in Delhi and other states. Indeed what all I found it was just from Google net and I was really not sure what is going to be happen. Many questions arose into my mind that how the operation is going to be done? How many days my son would be admitted? And many other questions were there.

Eventually, I got appointment with the MITR hospital via email with Mrs. Emily Paul who was very helpful and then we decided to go India for the treatment and finally reached the mentioned hospital on the 1^st December, 2014. In the same day, Dr. A. K Singal visited my child and he impressed me when he talked about the operation and we decided to operate him after two days. Then on the 3^rd December my baby’s operation was done.
The operation was done in a very professional way and successfully with no issue. Then I realized that I took a really right decision and found the right hypospadias doctor. It was amazing that in the same day my baby did not have any pain and discharged from the hospital but I requested to remain for some more days for betterment of the child.

We (me and my wife) have very good memories from the Hypospadias Foundation and MITR Hospital especially from Dr A.K.Singal and now we know why he is a renowned Pediatric urologist and one of the best Hypospadias surgeons in India. The staff of Hypospadias Foundation based in MITR Hospital is good and the nurses were really outstanding. I thank them too.

My little angel is doing very well after surgery with no issue and we overcome those all tensions and worries which we had in the past. I really appreciate Dr. A. K Singal and whole MITR team with professional communication and cooperation and your friendly environment.

Considering that our son had hypospadias which can have lot of stigma, we request you to keep his name and identity confidential. We would be happy to interact with parents whose children are suffering from hypospadias any time offline.

Thank you Dr. Singal.

Best Regards,

Mr M.H., Herat, Afghanistan

Case description:

Master F.H.,8 months old child underwent distal penile Hypospadias treatment at our hospital recently (Dec 2014). Father had written to us about a month back expressing a desire to travel for Afghanistan to India for the hypospadias repair surgery. They had sent us pictures of the penis via email and we could explain to them the type of anomaly and the surgery needed for the same. Fortunately, the father took very good and clear pictures as instructed and it was easy for us to understand even without examining the child. Ms Emily Paul and Dr Rajkumar coordinated the OPD appointments and then one fine day the baby was at our hospital in Navi Mumbai. We confirmed the hypospadias to be distal penile hypospadias and did the pre surgery checkup and fitness by a Pediatrician. We took up the baby for surgery on 03/12/2014 and surgery was done using Tubularised Incised plate urethroplasty (TIP repair) also called Snodgrass repair or Snodgrass urethroplasty. Originally described by Dr Warren Snodgrass, the TIP repair is one of the most reliable and common repairs done worldwide for distal and midpenile hypospadias in selected and suitable cases.

The surgery was finished in one hour and F.H. was allowed feeds after 3 hours of surgery. He was at his playful best by evening and we planned to discharge the baby. Parents were very worried about taking him to a hotel and requested to stay in the hospital for another week till the dressing and the catheter were taken out. In normal circumstances, we discharge most of the hypospadias surgery kids by evening of surgery but here understanding the situation we allowed them to stay for a week. Finally the catheter and the dressing were removed in 5 days and the parents took the child to Pune with them. I saw them on 15^th Dec 2014 once again before their final flight back home to Afghanistan from Delhi. He was doing very well and the penis had healed very nice with good cosmetic and functional outcome.

Staff and nurses were very fond of master F.H. as he was a very happy baby and used to come to everyone’s arms easily and used to play with them. He used to be in my lap all the time. All of us here at MITR Hospital and Hypospadias Foundation wish him the very best in life. And we all miss him.

About the Hypospadias Foundation & Dr A.K.Singal

Hypospadias Foundation in Navi Mumbai, India is the world’s only organisation committed and dedicated to treatment and care of children having hypospadias. Over last 6 years children from all over India and from more than 15 countries have benefitted from care at Hypospadias Foundation.

Dr A.K.Singal, Pediatric Urologist and Hypospadias Surgeon is an expert and renowned surgeon for management of children and adults with Hypospadias. Dr Singal and Dr Manish Dubey are close friends and together started Hypospadias Foundation in Nov 2008.

Dr A.K.Singal during Hypospadias surgery

Dr Singal can be contacted by filling up this form: Enquiry form for Hypospadias

Or you can call up Dr Rajkumar (Dr Singal’s assistant) at +919821261448

His clinic timings in Navi Mumbai, Thane and Mumbai are available here:

Clinics and Timings for Dr Singal

Hypospadias repair surgery videos by Dr A.K.Singal:

Contact Form for Hypospadias Foundation

Please fill all clinical details and upload pictures and clinical summaries (if available)

Tag Archives: hypospadias treatment in India

Contact Form for Hypospadias Foundation

Contact Form for Hypospadias Foundation