Same-day surgery can treat hypospadias

Walid Farhat, MD performing surgery
UW Health pediatric urologist Walid Farhat, MD performing surgery.

Same-day surgery can treat hypospadias, a birth defect affecting a baby boy’s “pee hole."

Because it is so seldom discussed publicly, parents are often surprised to learn that a birth defect that affects about one in 250 baby boys – known as hypospadias – is more common than one might think.

Instead of peeing through a hole located at the tip of the penis, babies with this condition have their “pee hole,” or opening of the urethra, located in a slightly abnormal place. Sometimes it is off to one side. Other times it may appear further down the urethra, occasionally reaching close to the anus.

More than a cosmetic problem, hypospadias can make boys self-conscious as they get older. It can be difficult for these kids to avoid spraying their feet while peeing, so many boys choose to sit while urinating. Some may notice a downward curve of the penis or incomplete foreskin, resulting in a hooded appearance. Regardless, having an abnormality like this can be psychologically harmful because it can be very difficult to talk about.

Nobody really knows what causes hypospadias. Some think it has a genetic origin. Other theories suggest it may have to do with environmental factors, such as pollution or insecticides.

Regardless of its cause, the good news is that hypospadias can almost always be remedied by surgery, ideally performed when the child is between 6 and 18 months old. While children with very mild cases may do fine without surgery, UW Health pediatric urologists are available to meet with any family whose child is diagnosed with hypospadias.

Arriving at a shared decision about surgery

“We spend as much as time as the family wishes to make sure every question is answered so we arrive at a shared decision about surgery,” says UW Health pediatric urologist Walid Farhat, MD, who has operated on more than 1,000 patients with hypospadias over the past 20 years.

Kami, a south-central Wisconsin mother whose 16-month-old son was born with hypospadias, was referred to UW Health pediatric urologist Walid Farhat, MD, by her local pediatrician.

“Dr. Farhat assured us that this was more common than we thought,” Kami says. “Knowing that he has done more than 1,000 surgeries on boys like ours assured us that he would be in good hands.”

As Dr. Farhat advised, Kami and her husband waited until their son was 7 months old to have the surgery. When the day came, they arrived at American Family Children’s Hospital at 8 am for the surgery, which typically lasts between one and two hours. By 3 pm, their little guy was doing well enough for the family to head home.

Family decided that sooner was better

“The hardest part was knowing he had to go under anesthesia,” she says. “Of course we had the option of waiting on surgery, but the more we thought about it, the more we didn’t want this to be something he had to deal with as he got to be 3 or 4 or even older.”

Once her son was home for a week, he was almost totally recovered.

“The doctors and nurses were great,” Kami says. “They really put us at ease by assuring us how many of these surgeries they have done and by explaining every little thing they were going to do and why they were doing it.”