Hypospadias Treatment in Lahore

August 22, 2020 by admin0

What is Hypospadias?

Urethral opening proximal or ventral to the normal granular location.

Caused due to arrested penile development


  • Ventral meatus
  • Ventral curvature
  • Dorsal hood of prepuce


  • Downward glans tilt
  • Deviation of the median penile raphe
  • Ventral curvature
  • Midline scrotal cleft
  • Scrotal encroachment onto the penile shaft

If you want more information call us 03171172688 or LIVE CHAT with our experts…!

Development of Hypospadias:

Cloacal endoderm:

  • Primitive urethral plate, ventrally

Medial endoderm:

  • Male urethra, ventrally

Lateral Ectoderm:

  • Skin of penile shaft and prepuce
  • Layers fuse posteriorly to anteriorly, forming median raphe.
  • Arrest in fusion causes hypospadias
  • Abnormal development of growth plate, disproportionate corpora and fibrosis leads to penis curvature

Main Differential Diagnosis:

Characterized by asymmetrical perpetual development but normal granular meatus

Varient terms:

  • Almost 1 out of 300 males affected by this disease.
  • Risk is 13 fold in 1st degree relatives
  • 8% patients have father with hypospadias, 14% have male siblings with hypospadias.
  • Some are under hypospadias treatment

Risk Factors of Hypospadias in Next Child:

If your one child has hypospadias than the next one also affected and need hypospadias treatment.

  • 12% with negative family history
  • 19% if cousin or uncle has hypospadias
  • 26% if father or sibling has hypospadias
  • Placental dysfunction
  • Low birth weight
  • Preterm birth
  • Pre pregnancy maternal obesity
  • Extreme of maternal age
  • Assistive reproductive techniques

Hypospadias Associated with Normalies:

  • Undescended testes of 9% chances
  • Inguinal hernias 9% chances
  • Upper urinary tract anomalies
  • Utriculus masculinus is incomplete mullerian duct regression
  • Intersexuality needs to be ruled out especially in cases of non-palpable testis


  • 90% are isolated penile defects. Rest are syndrome namely.
  • Smith lemli Optiz syndrome
  • WAGAR syndrome
  • Wolf Hirschorn syndrome
  • 13p deletion
  • Hand foot uterus syndrome

Types of Hypospadias:

Anterior hypospadias:

  • Granular
  • Coronal
  • Subcoronal


  • Distal Penile
  • Mid shaft
  • Proximal penile

Posterior hypospadias:

  • Penoscrotal
  • Scrotal
  • Perineal

Diagnosis and Hypospadias Treatment:

Zaib Hospital have specialist Andrologist doctors for hypospadias treatment in Lahore.

  • Diagnosis is clinical
  • Imaging not required in cases of isolated hypospadias, regardless of severity
  • Surgery is the hypospadias treatment of choice
  • Performed at the age of 3 months or later

If you want more information call us 03171172688 or LIVE CHAT with our experts…!

Features of Hypospadias:

  • 90% hypospadias are isolated, only 10% are syndromic
  • Urinary tract imaging is not required for isolated cases
  • Surgery is the hypospadias treatment of choice to performed at the age of 3 months or older
  • Penile blocks are considered superior to caudal blocks for surgery owing together risk of penile engorgement
  • Ventral curvature at greater than 30 degree, corrected by dorsal plication
  • More than 30 degree by degloving and dissection
  • Tubularised preputial flaps have better outcomes as compared to only flaps
  • For distal repairs follow up is desired at 2 months and 8 months post operatively, while for proximal repairs, annual follow up is recommended till puberty

Risk Factors and Complications:

  • Proximal meatus
  • Re operation
  • Glans width less than 14 mm
  • Fistula
  • Glans dehiscence
  • Meatal stenosis
  • Neourethral stricture
  • Diverticulum at the flap site
  • BXO
  • Graft contractions
  • Obstructive urinary symptoms
  • Sexual dysfunction

If you want more information about hypospadias treatment call us 03171172688 or LIVE CHAT with our experts…!

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