Hypospadias Definition:
What is Hypospadias?

The simplest hypospadias definition is: pee hole in the wrong place.

Medical obfuscation takes that easy to understand hypospadias definition, banishes the “Keep It Simple” principal, and buries “kid's pee hole in wrong place” under a mountain of types, grades, degrees, descriptors and classifications.

At the Sava Perovic Foundation, we work hard to define hypospadias in a way that is easy for parents and patients to understand.

You will find lead surgeon Dr Rados Djinovic (pronounced RAH-DOSH JIN-O-VICH) is a man of few words who swiftly gets to the point and is full of positive energy. Evaluations are amazingly short, clear, concise, simple.

Here is everything you need to know about hypospadias and some info you might not need but may find interesting.

WHO Does Hypospadias Affect?

• human embryos
• 1 out of 125 boys (USFDA)
• not less than 1:300 males
• some girls (female hypospadias 1:500,000)

WHAT is Hypospadias?

• misplaced urinary openings (medical jargon: “urethral meatus”)
• abnormal penis development in womb (penis deformity)
• most common male birth defect (birth abnormality)
“From Greek word ‘hypo’ (under) and ‘spadon’ (fissure)”
• found at birth (medical jargon: “congenital”) genital deformity
• urethra opening deformity (pee-hole abnormality — medical jargon: “anterior urethral development defect”)
• urinary tract does not go to tip of penis (medical jargon: “penis urinary outlet misplacement disorder”)
• one component of testicular dysgenesis syndrome
• from Greek word “hypo” (under) and “spadon” (fissure)

WHAT are Possible Effects of Hypospadias? Associated Problems?

• messy spray instead of controllable urinary stream

(after MK Crowell 2010)
• prone to lower urinary tract infections (UTIs)
• bent penis curving down (medical jargon: “hypospadias chordee”)
• sexual dysfunction
• hindered reproduction
• higher risk of testicular cancer in adulthood
• gender misdiagnosis
• gender identity confusion
• painful erections
• inability to urinate standing

(after MK Crowell 2010)
• emotional trauma
• emotional instability
• feelings of guilt
• aberrant behavior
• decreased quality of life
• embarrassment
• stigmatization
• nuisance
• low self esteem
• torment by peers (classmates)
• ridicule by partner
• penile torsion or rotation (associated)
• smaller penile size (associated)
• mushroom-shaped glans (associated)
• incomplete foreskin (associated)
• hood-like skin instead of foreskin (associated)
• inguinal hernia (associated)
• cryptorchidism | undescended testicle (associated)
• infertility (associated)
• gonadal dysgenesis (associated)
• intersex misdiagnosis | ambiguous external genitalia (associated)
• premature birth (associated)
• low birth weight (associated)
• polythelia [a third nipple] (associated)

WHERE is Hypospadias Found?

• underside of the penile shaft (hypospadias anatomy medical jargon: “ventral surface”)
• glans
• penile shaft
• scrotum
• perineum
• between clitoris and vagina in females (medical jargon: “distal female hypospadias”, “proximal female hypospadias”)

WHEN Does Hypospadias Occur?
WHEN Can Hypospadias Repair be Done?

• occurs 6-7 weeks after conception
• more likely to occur in sons born to mothers 35 or older
• boys 6 months old up to elderly men get hypospadias repair surgery
• best time to get surgery depends on expert opinion of surgeon based on unique details of case

WHY Hypospadias?
(see “Cause of Hypospadias”)

HOW Much?

• increasing incidence of hypospadias worldwide in past 30 years averaging about 2% annually
• hypospadias cases doubled during past 40 years in Europe & North America (USA CDC)
• hypospadias most common in Caucasians, Jews & Italians
• 14-28% more likely to reoccur among immediate relatives

(after MK Crowell 2010)
• severity varies but is continually INCREASING
• hypospadias surgery success rate is not high if defined as fully functional and aesthetically pleasing result without complications or more surgery
• 24-79% of patients need more surgery
• 12-30% surgery failure rate worldwide, maybe higher (medical jargon: “more successful than in the past”)
• 15% surgery failure rate for proximal hypospadias
• 95% “success” rate reported by originator of popular, easy-to-perform tubularized incised plate procedure (only 85% “success” reported by others) still results in 35% incidence of fistula & urethra stenosis in mild, Grade 1 or 2 hypospadias patients & 66% incidence in severe, Grade 4, proximal hypospadias cases
• hypospadias surgery cost: few thousand US dollars to several thousand. Need exact cost?
• 1-4 hours of surgery
• 1-2 nights in hospital
• 3-7 days in Belgrade total
• major healing of hypospadias repair in one month
• complete healing in six months

HOW to Repair Hypospadias?

• only surgery
• get help from HIGHLY specialized center committed to supreme surgical results and excellence in patient care
• use ONLY an international leader in urogenital reconstructive surgery
• entrust your child ONLY to a surgeon highly experienced with hypospadias correction such as Dr Djinovic in Belgrade, Serbia.

Define “Highly Experienced”

What do we mean when we say Dr Djinovic is: “highly experienced”?

Dr Djinovic continually improves results while performing the most challenging and complex genitourinary surgery:

• up to 17 hours per day;
• as many as 11 hours and and seven procedures for a single person in a single session;
• about 45 surgical sessions per month;
• as much as 200 hours of surgery per month; and
• approximately 24,000 hours of hands-on surgical experience in the past decade alone since joining the Sava Perovic Surgical Team — not counting the four years of surgery Dr Djinovic did before that.

     

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