Hypospadias repair

Hypospadias is a common condition in boys, present from birth: the opening through which urine comes out (the meatus) is not at the tip of the glans but lower down, on the underside of the penis. It is often associated with an incomplete, "hooded" foreskin and sometimes with a curvature of the penis. Depending on the position of the meatus, hypospadias is described as distal (near the glans, the most common form), mid-shaft or proximal (near the scrotum). The aim of surgery is to move the meatus to the tip of the glans, straighten the penis if needed and give it as natural an appearance as possible, so that the boy can later urinate standing up and have a normal sex life. The operation is generally performed between 6 and 18 months of age. The surgeon rebuilds the missing part of the channel using nearby tissue; simple forms are corrected in one stage, severe forms sometimes in two. A small catheter is often left for a few days to protect the repair. A child with hypospadias should not be circumcised before the surgeon's advice, because the foreskin may be used for the repair. At Clinique Pasteur Tunis, the child is operated on by a paediatric surgeon, with paediatric anaesthesia and suitable pain relief. The team shows the parents the care to be given at home.