HYPOSPADIAS
Hypospadias, popularly known as half circumcision or prophetic circumcision, refers to the condition in which the external urinary hole opens to the bottom of the penis, rather than to the tip. Due to the disorder in the sexual development stages in the womb, the external urinary tract cannot be fully formed and cannot progress to the tip of the penis. There are many different degrees of hypospadias. If the external urinary tract has completed its development very close to the tip of the penis and remains there, this is called “glanular” hypospadias. This is described as the mildest form of hypospadias. The urinary hole can be opened in the middle of the penis or at a lower level. These are called “penile hypospadias” and are considered to be of moderate severity.
In the most severe cases of hypospadias, the external urinary hole is angled at the root of the penis and even between the bags that carry the testicles. Such cases, called penoscrotal hypospadias, are usually caused by significant hormonal problems in the early sexual development of the embryo. The primary disease that causes this type of hypospadias is "pseudohermaphroditism", also called hermaphroditism. Testosterone production is very important in the first three months of the embryo's sexual development. If there is not enough testosterone during this period, male genital organs cannot complete their development and hypospadias develops.
Treatment: Surgery. The type of surgery is determined according to the degree of hypospadias.
Hypospadias surgery is performed with special magnifying glasses and hair-thin stitches. Hypospadias, which is seen in approximately one in every 300 boys, can lead to infertility if left untreated. Since the external urinary hole is not at the tip, the semen cannot be expelled forward and the sperms go out of the vagina. For this reason, sperm cannot reach where they need to reach, that is, the tubes. and cannot fertilize the egg. Children with hypospadias may also have problems urinating because the external urinary opening is quite narrow. Hypospadias needs to be treated surgically between the ages of 1-2 at the latest, before sexual identity is formed. The most important goal in surgical intervention is to remove the urinary opening to the tip of the penis. Penile curvature, which often accompanies hypospadias, also needs to be corrected in the same session. This ensures that both urine and semen can be expelled forward. In severe cases of hypospadias, a single session is not sufficient and multiple surgeries may be required. In severe cases of penoscrotal hypospadias, it may be necessary to apply hormone therapy to lengthen the penis.
Surgical results are generally satisfactory. After surgery and treatments performed at an early age, a functional and normal-looking penis can be obtained in almost all of these children.
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