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Hypospadias Surgery - Art and Science


Frequently Asked Questions

Questions regarding corrections of foreskin

(for individual questions please send an email)

  1. When should the correction of the foreskin be performed?

  2. What are the possibilities and how ?
  3. Why should not my son have the forskin reconstructed at the same operation with the hypospadias correction ?
  4. Why should not my son have cirumcision during the hypospadias operation?
  5. What should we take care of after the foreskin operation?

  1. When should the correction of the foreskin be performed?


Professor Hadidi prefers to leave the foreskin intact during the operation of hypospadias correction. He prefers to leave it because it would be needed in case complications (e.g. urethral stenosis, intractable fistula or complete wound disruption) occur and the foreskin would help to correct the complications.


  1. What are the possibilities and how ?

About 95 % of patients with hypospadias have incomplete prepuce (I.e. foreskin above and no foreskin below).  Prof. Hadidi prefers to wait 6 months after hypospadias correction to make sure that everything has healed well without complications before operatng on the foreskin. There are two possibilities: The first is to perform foreskin reconstruction. About 70 % of parents in Germany, Austria and Switzerland and almost 90% of parents in Southern Europe (Spain, Italy  and Greece) prefer foreskin reconstruction. The other possibility is to perform circumcision. This is usually the case among Jews and Moslems.

Either operation takes about 30 min. The complications are more or less the same. Each has advantages and disadvantages. The final decision has to be taken by the parents. During the second operation, Professor Hadidi examines the new urethra to ensure that it is wide enough with no complications and makes the meatus wider or more cosmetic if needed.

Foreskin corrections

Foreskin rekonstruction:

a: b:

c:   d:

a: Foreskin reconstruction, end of operation, after distal hypospadias
b, c: 2.5 months after operation
d: 6 months after operation

Circumcision:

a:   b:   c:

d:

a, b: immediately after operation
c: 1 day after operation
d: 3 months after operation


  1. Why should not my son have the forskin reconstructed at the same operation with the hypospadias correction ?

Because it interferes with healing and secretions would accumulate between the foreskin and the glans. This does increase the chances of infection and failure of the repair.

  

a:   b:   c:

 

Foreskin was reconstructed during hypospadias-correction. By pulling back the foreskin you can see that the opening of the meatus is still at the origin place.


  1. Why should not my son have cirumcision during the hypospadias operation?

Most surgeons perform circumcision during hypospadias repair. Prof. Hadidi prefers to leave it in case complications occur and the foreskin is needed to correct the complications.

a: b:  c:

a/b: There is not a lot healthy tissue available for a successful correction

c) At the end of operation through Prof. Hadidi

 


  1. What should we take care of after the foreskin operation?

It is very important to avoid retraction of the foreskin for at least one month after surgery. Otherwise the whole operation would fail and the wound would disrupt completely. This should not be done neither by the parents nor by the pediatrician looking after the child later on.

 


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