Renal and urinary issues

  • Hypospadias includes a spectrum of congenital anatomic defects related to inadequate development of the urethra and ventral compartment of the penis.
  • Determining appropriate follow-up for patients with hypospadias long-term remains controversial, because most patients with hypospadias do well with minimal further urologic issues after initial repair.
  • About one in four patients with hypospadias require one or more subsequent surgical revisions later in life, including a large proportion of those with complex proximal defects.

Reasons for follow-up

Even after successful initial repair, individuals may report several bothersome urinary symptoms including spraying, post-void dribbling, and downward deflection of the urinary stream later in life.

Patients can also present with concerns regarding sexual function and fertility. Recurrent penile curvature can occur later in life, especially around the time of puberty, when an increase in systemic testosterone spurs increases in penile length.

Management is guided by the degree of bother and may be complicated by the need to manage the urethra in such cases as recurrent curvature.

Transitional urology
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