Anyone NOT had their DS's hypospadias fixed? Worried about surgery that's basically just cosmetic

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My DS (13mo) has just been given a date for his hypospadias surgery. (Hypospadias = misformed urethra in males) It means a general anasthetic, a night in hospital and a catheter for a few days. The thing is that he only has very mild hypospadias - his foreskin doesn't look like his cousin's, true, but the surgeon said he'd not have any problems with weeing or sex in the future.

So, my question is - do we take DS in for a pretty major operation that is essentially cosmetic?

Poor you, that's a horrible decision. We were told my first son would need surgery for two cysty type bumps on his foreskin but we refused because of the major surgery issue. I don't know about hypospadias though. It might be different. But I sympathise with your decision.

Boys' willies do change a lot though. Have you seen pictures of grown men's hypospadias? Is it really that bad?

I am a bit wary of googling men's willies on the family computer so I'm not doing it! But I would if I were you!

ok I just did a google and couldn't make head nor tail (excuse pun) of the images. But there are loads of websites out there it seems.

I have had 2 sons with hypospadias (and one without). Both my sons have had the op. I understand your feelings - I was very reluctant to do something that was basically cosmetic too. It tore me apart sending my innocent unknowing boys into an operating theatre. But dh, my father, my brother and the male surgeon all explained to me that it would matter to my boys when they were older and did not look the same as others, so I ranked their male perspective over my motherly instincts.

Both boys were fine btw - minor complications but nothing that meant I regreted putting them through the surgery. I am happy to talk about it with you if you like.

I found this on wikipedia

"First degree hypospadias are primarily a cosmetic defect and have little effect on function except for direction of the urinary stream. If uncorrected, a second or third degree hypospadias can make male urination messy, necessitate that it be performed sitting, impair delivery of semen into the vagina (possibly creating problems with fertility), or interfere with erections. In developed countries, most hypospadias are surgically repaired in infancy. Surgical repair of first and second degree hypospadias is nearly always successful in one procedure, usually performed in the first year of life by a pediatric urologist or a plastic surgeon."

I have to say, any surgery is better performed when a child is too young to be told about it! Well, thats my opinion - my dd had tooth removal under GA at age 8 and was hysterical and distraught - when her cousin was offered hernia repair at 3 or leaving it for a couple of years, we all voted for the NOW - as she is similar emotionally to my dd.

I do tend to think that the nhs dont necessarily offer ops that are 100% UNNECCESSARY - you know? look on wikipedia under adult male hypospadias - it show a picture of an erect male unoperated on penis - it DOES look pretty different

I'm not sure its completely 'cosmetic' I have googled a little and it seems that he will pee out of the underside of his willy instead of the tip of his willy

I dont thnk you will see anythiing different so 'cosmetic' isn't quite the word for it

have they explained properly why they are ding it??

surely they wouldsn't do it for no medical reaosn

if it was cosmetic they wouldn't have routinely given you out an app
they would have waited for you to choose to do it..or not

I don't think it is purely cosmetic. Hypospadias has a quite profound effect on an area that essentially 'defines' a man. I have seen hypospadic penises (am a nurse) and while it isn't essential surgery, I think your DS would thank you for it later.

You are both right really - it is not purely cosmetic. Neither of my boys learnt to wee standing up when other boys did. Ds1 did develop a way of weeing standing up in which he held his penis at an angle so the stream went straight ahead, but ds3 used to wee backwards and sometimes couldn't even get his stream to go into the loo when he was sitting on the seat. Standing up would have meant wetting himself like a girl would if she stood to wee.

Also, there is a very clear difference to the appearance of the penis, even when they are boys. The foreskin does not cover the end of the penis and in my boys' cases, only went round half their penises. Some surgeons take off the foreskin during the op so the penis looks like an ordinary circumsized penis, but both my boys were lucky to have surgeons who managed to reconstruct the foreskin so they now look much similar to their brother who was born without hypospadias.

So it is not simply a cosmetic op. It does have real practical and psychological implications for boys too. But I know what the OP means when she says purely cosmetic as this is not a life saving op or even one that will allow her son to for instance conceive children where previously he could not. But OP if you think of the psychological benefits to your son in later life, does that help you?

These are all the arguments that DH and I have been through. My gut feeling is that we should do it becuase it'd be best to do it while he's tiny. Not ever having owned a penis I kind of think it's more DH's decision and he's midly against it. I do think, though, that he's not admitting to himself that part of his reasons for being against it is squeamishness at having someone operate on DS's penis. Plus he's a bit scared it'll go wrong and end up with a total circumcision, which he seems to be really against for reasons I'm not sure of.

The surgeon that would be doing the op, who we both really liked, basically said it's such a mild case that it's cosmetic. Shouldn't be peeing problems, which I would think a convincing reason to have it done. Last night after a few beers we went through the reasons for doing it. Bullying: DH said that he didn't buy the boys in the showers argument as he went to a boys school and had never noticed anything odd about another boys pecker (presume you'd get beaten up for checking them out?). Sex: the first time anyone sees your bits for real is excruciatingly embrassing anyway, and we'd both like to think that DS will find a partner who wouldn't be so shallow as to care that his foreskin doesn't go all the way round. Perhaps we're being naive about the pschological implications?

DDsgirl - good to hear that your DSs ops went well. When we first found out about it I did a MN search and found lots of sensible advice and stories of successful ops. DH googled and found lots of horror stories with extreme cases of malformation. He made me promise never to google the condition!

Perhaps we just need to ask to go back and see the surgeon again, would the NHS let us do that?

Of course they would!

My DS had hyperspadia fixed in March. He had very messy foreskin but no probs with urethra so essentially it was cosmetic, but we didn't want to give his future classmates ammunition for bullying. As someone who had a visual difference to my classmates and had lots of grief as a result no way did I want him to feel the way I did. He now has a lovely looking penis (?!) and you would never tell how it started off.

DS did not require catheter though and the fact that your DS will require one does imply it's a bit more complicated than being purely a foreskin tidying job in his case. Yes he could have the operation later, but we felt would be easier to manage while he still small and in nappies. Yes is was very stressful for us, but he was only under the weather for 24 hours, then back to charging round like a loon so I do not regret it at all and I don't think give then quality of the result he will object in future years to the call we made.

BTW we were convinced DS would be circumcised because it seemed like an easier thing to do than rebuild. Our surgeon said he had fine over 300 rebuilds and only about 2 circumcisions because actually rebuilds are easier, quicker and have better results. Op was dine Alderhey

Wing, interesting to hear the rebuild vs circumcise stats, of your surgeon at least. Over dinner DH said he doesn't want circumcision because foreskins are fun! Fair point, but it doesn't half feel weird to be discussing our wee boy's future sex life (!).

As for bullying - I was bullied at school because of the way I spoke, oh and because I stood up for a friend with red hair who was being bullied first. Part of me thinks we shouldn't give the future bullies any ammunition, but another part of me feels that it'll probably happen anyway and that one of the roles of a good parent is to help their child have the strength to rise above it.

Lou - I guess we need to speak to the surgeon again.

btw - not in any way knocking anyone else's decision or trying to be argumentative. Feeling very confused and it's very helpful to hear other people's experiences.

Just to clarify, DS was rebuilt despite the fact he had less than half a foreskin. I would also far rather he kept it, and luckily that was possible.

We were talking to someone the other day as their son has one too and they just starting to see doctors now. we came to the conclusion that the major problem with discussing hyperspadias is that it concerns The Penis and that therefore we wrap ourselves up in even more doubt, guilt, uncertainty and psychological analysis. If we were talking about having a minor operation on a less gender defining part of the anatomy, would be totally different debate.

Oh that is interesting. My guess it that he's got well more than half there, so I suppose that means a higher odds of success. We've asked to speak to the surgeon again.

Thanks for all the advice.

Thought I'd bump this thread with our story, in the hope of hearing of anyone else's similar experiences ...

DS is 12 months and has been scheduled for an op to correct his mild hypospadias next month. I emailed his consultant and asked:

1. Whether the abnormality would be noticeable to casual observers, e.g. in public toilets, changing rooms, etc, if it's not corrected.
2. Whether he would have problems having sex or conceiving a child if it's not corrected.

His consultant answered 'no' to both, and said that surgery to correct mild hypospadias is essentially cosmetic.

DH and I have decided not to go ahead with the op, but to leave DS to make the decision when he's old enough, if that's what he wants. For a start, I have strong reservations about subjecting DS to surgery that is not medically necessary, when he can't consent himself and when there's a fairly high risk of complications (1 in 20 - the consultant views this as a low risk, but I disagree). Also, I think it would send the wrong message to DS: it would be reasonable for him to conclude that he wasn't 'perfect' enough for us, and that it's important to conform and to avoid being different. I would rather send him the exact opposite message. Not that I judge any parents for making a different decision.

I should also mention that DH is hugely sporty and always has been, and so the issue of how the hypospadias might affect DS in the 'changing room environment' is a big one for us. But since the consultant says he doesn't think mild hypospadias would attract attention, we're happy to leave it. We're going back to see the consultant in a year's time, but that's mainly to have a chance to review our options. I think we're set on leaving DS to decide for himself.

I would be interested to hear of anyone else who's having to make a similar decision at the moment ...

I forgot to say in my post that I found this website really helpful, especially the accounts from adults with hypospadias: www.hypospadiasuk.co.uk/

We haven't.
DS2 can make his own mind up. Ds 1 seems fine (just a circumcision, v mild case).

I thought the website was sad!! I bet there are lots of happy adult males with hypospadios who just haven't been included on this site.
Loneliness and isolation? - when you think what some kids have to deal with re their health - that surely speaks of our attitude to it (as a society) not the actual hypospadios itself.

Hey how are your boys doing now? Is there any difference in appearance now? Did the docs stimulate them to check on their post op visits? Ive read things like that on the internet. Please help me cuz im still deciding whether to operate or not reading horror stories post op and the follow up visits over years. And also does this operation affect childrens sexually