Benefit From Taking The Second Opinion For Failed Hypospadias Surgery - Dr Prash

Posted by Dr Prashant Jain on February 24th, 2021

Introduction

Hypospadias surgery is done to correct the hypospadias in children. The complications of surgery reduces if the surgery is done at an early age. Despite advanced technologies, there may be complications after hypospadias surgery.

Why Complications Occurs After Hypospadias Surgery?

Post-surgical complications after hypospadias surgery occur due to the following reasons:

• Accumulation of scar tissue
• Reduced blood supply
• The reconstructed and original tissue does not unite properly.
• Transplanted tissue necrosis
• Hematoma
• Urine extravasation
• Post-operative infection
• Poor surgical techniques

Complications Of Hypospadias Surgery

The success rate of hypospadias surgery, in the past, was poor. With the advancement of technology and trained surgeons, the complications with hypospadias surgery are fewer. However, in certain cases, children may suffer hypospadias surgery complications. Some of the complications with hypospadias surgery are:

Curvature: The curving of the penis in hypospadias is termed as chordee. In some hypospadias surgery, the chordee is not completely corrected by the surgeon. This results in residual chordee. The surgeon should correct the chordee in the first surgery. The rate of complications increases in future chordee correction surgeries.

Stricture: Surgeon forms a new passage for the flow of urine. However, in failed hypospadias surgery, there is a constriction in the new passage. This results in painful urination along with a narrow stream of urine. The child may require to apply pressure or strain for urination. The stricture may occur at the top of or inside of the passage.

Uretherocutaneous fistula: This is the most common complication after hypospadias surgery. This occurs due to the abnormal hole on the skin of the penis so deep that 2-3 drops of urine are leaked from the holes. This may occur due to hematoma, poor surgical techniques, and infection.

Penile torsion: Penile torsion is the rotation of the penis on its axis. Penile torsion may be present along with the hypospadias or is a complication of hypospadias correction surgery.

Poor appearance: Hypospadias surgery is considered as functional and cosmetic surgery. It should be the aim of the surgeon to perform the surgery in such a way that there is a positive cosmetic outlook.

Diverticulum: In this complication, there is a swelling in the urethra. The swelling is due to the ballooning of the urethra while passing the urine. The patient feels difficulty in passing urine and may have a urinary tract infection.

Dehiscence: In the glans dehiscence, there is the opening on the head of the penis that was closed during the surgery. This results in urine spraying during urination. It may be due to reduced blood supply, infection, edema, and poor dressing removal methods.

Symptoms Of Hypospadias Surgery Complications

Following are the symptoms of hypospadias surgery complications:

• Painful urination
• Narrow strain
• Pressure during urination
• Urinary tract infection
• Leaking of urine
• Lumps on penis

Taking The Second Opinion For Failed Hypospadias Surgery

The success of hypospadias surgery may be determined through the ease of urination and the extent of erection. The cosmetic appearance also indicates the success of hypospadias surgery.

It is important to note that as the surgeons are also humans, and they may also have a mental roadblock. The primary surgeon may not be able to handle the complications effectively. It is also possible that due to mental roadblock, the revision surgery done by the same surgeon may not be that successful.

Thus, to look at the problem from altogether a different perspective, a second opinion from a hypospadias specialist may be of significant help. Many times, looking for a fresh solution for the same problem may help in finding out the solution.

Teleconsultation For The Second Opinion

The second opinion for failed hypospadias surgery is possible through teleconsultation. Because of the availability of high-end cameras and excellent internet facilities, patients may have effective teleconsultation with hypospadias surgery specialists. If the videos, images, and reports provided by the patients are enough, then the doctors may provide advice through teleconsultation.

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