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Questions regarding correction of the foreskin:

60. 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 and 30 % of Paretns in Germany, Austria and Switzerland.

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 fine adjustment of the glans and meatus as well as the foreskin.

Foreskin correction after hypospadias operation

 

Foreskin reconstruction, 2.5 months after operation

Foreskin reconstruction, end of operation, after distal hypospadias

2.5 months after operation

Foreskin reconstruction after Hypospadias Repair

2.5 months after operation

6 months after operation

Circumcision:

Circumcision at end of operation, 6 months after Hypospadias Repair

Circumcision directly after operation, 6 months after Hypospadias repair

Cirumcision, at end of operation, 6 months after hypospadias surgery

Cirumcision, at end of operation, 6 months after hypospadias surgery

Circumcision on day after operation

Circumcision, 3 months after operation and Hypospadias Surgery

Circumcision, one day after operation

3 months after circumcision after hypospadias repair


61. 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.

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.


62. Why you do not recommend that my son be circumcised 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.

Circumcision during Hypospadias Surgery - Complication

Circumcision after repair Prof. Hadidi

There is not a lot healthy tissue available for a successful correction

at the end of operation through Prof. Hadidi


63. What are the precautions 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.

Foreskin too early retracted


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