hypospadias repair

[half-pigeon]

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[PuppyFluffer]

If your son can urinate ok right now, his penis is doing it's only necessary function at this point in his life. Assuming that is the case, can you take a deep breath and give yourself some time to get answers to your questions.

It's perfectly natural that more questions have come up since your appointment. I am glad that you have written them down. Can you schedule a face to face consult with the doctor to ask your questions and get answers? You need to have fully informed consent before you can competently consent to any surgical actions. I think you are well within your rights to have an appointment to have these questions answered. And if your doctor is hesitant to make this time with you or does not answer your questions in a valid and competent manner, get a new doctor if possible.

It can be very overwhelming to advocate for your child in the face of the medical community. I completely know what that feels like and have recently been through it myself for a different issue.

I think learning the time line of action will help you to re-group and assemble your questions and find answers. (Like is this necessary to do before he reaches a certain age?)

I do know that many European doctors do not circumcise to repair hypospadias. Is this a technique that would be possible for your son? Does your doctor know anything about it?

I don't have experience with this issue but I believe there are some here who may know more.

[half-pigeon]

d

[PuppyFluffer]

You have the advantage of having some time before you have to make decisions. This will be a good learning experience for you. I predict that no matter what you decide, you will look back and have some things you would have done differently. Knowing this in advance might help you to evaluate situations differently. When you are questioning something, you can look at it and ask if you think you are making a sound solid decision based upon knowledge or are you being pressured to decide without knowing. Adk yourself if you feel empowered or do you feel the medical community is taking your right to decide away (aka are you being coerced).

I am skeptical in medical settings because I WAS that sick child in a hospital (when parents were not nearly as present with their kids for medical procedures) and I remember feeling victimized and totally powerless. It was not a fun experience but it has been a great asset in making me an educated consumer of medical advice.

I recently had to advocate for my son against an allegation of intentional abuse after seeking medical care for a bump on his head after he fell. I cannot imagine a more educated and questioning parent than myself and still I got slammed by the medical community. I was forced to consent to things I believe to be detrimental to prove that I was innocent of hurting my child. I could have refused and lost temporary custody of him. That was a risk I was not willing to take. They attempted to retract his foreskin after being told not to, after agreeing not to and continued to retract when I said STOP - at which point I physically removed her from him. I know how hard it is to advocate. Many doctors don't like questioning parents. It is a threat to them and many of them just don't have time to deal with you. It's far easier to label you a nutcase and be dismissive of you than it is to actually follow their medical guidelines of assuring you have informed consent. (I know, in my son's medical records, I am labeled "distrustful" and "Mother is possessive and defensive with this child." I am also called "angry about admission". No, I willingly went there for admission for observation. [I transfered there from a small hospital.])

There are many wonderful caring doctors and nurses. But, they all work within a system and it's been my experience that when you systemize something, you take a very important level of care and concern out of it. Each of us is an individual and you can't cookie cutter stamp us all with the same treatment. Sadly, the medical community often does not have time for those that don't just go with the flow.

As for getting a second opinion on a surgery....I am sure you are right, any other surgeon will recommend repair too. The questions are what kind of repair and when? and that is something there might be varying opinions on.

I know if it were me, if I could have a voice in what happens to my body, I would want that. If it could wait until I was 10, 12, 15.....when it could be explained how the body usually forms in utero, how mine formed a bit differently and that there are options to make mine more like the normal....I would want to be a part of that process - to understand it all.

You also don't know how techniques will change over time. I suspect that the procedures will evolve and be a bit different in the future than what they are now.

Please don't think I am second guessing you or second guessing your doctor. I am just trying to speak from the point of view of a child patient (having been one) and from one who is very questioning and seeking of information about medical interventions.

The only function of the penis at this point it to remove urine from the body. If he can pee, you've got a little time.

[mysticmomma]

A big : to puppyfluffer (I first typed that out as puffyflupper).

[Dev]

Good for you for asking advice regarding your infant son's hypospadias. I am no doctor or expert on your son's condition but if he was my little boy I definitely would NOT consent to any such surgery that would remove any part of his healthy penile tissue, specifically his prepuce (nerve enriched foreskin). Why... because he has no "disease" and his condition which supposedly calls for "repair" is a cosmetic surgery since your boy is able to urinate and his cordee is not causing pain, right?

The statement that your son can't pee standing up is nonsense. Your son will learn how to aim like all boys. He just won't be able to stand at the toilet or urinal with "no hands" without the risk of hitting his shoe! The fertility concern is a bunch of crap too. The doctor is assuming your son's ejaculation won't hit or reach the cervix to increase the likelihood of meeting up to fertilize an egg. As long as your son is able to deposit sperm inside a vagina, he can get a woman pregnant. If it becomes a detriment when he is trying to conceive with your future daughter in law, his wife can be advised to lay on her back after sex with pelvis elevated a bit to let gravity do its trick.. . and there are a few other ways using common sense and imagination to increase the probability of fertilization. Your son has 25 to 50 years to consider being a dad, it is the furthest thing from his mind right now! Besides, lessening the probability of impregnating can be a positive effect for a lot of men during a time in their lives, like during college years!

Lastly, I personally would not repair the hypospadias since your son can decide on the benefits and risks of this cosmetic procedure when his penis has finished growing. I have read that the best time to repair such conditions as your sons is when a child is still young. However, these studies are probably written by circumcised, circumcising surgeons. Besides, 20 yrs. from now medical science and surgeries will be even more advanced. If you decide to have the surgery done on your son when he is young, I would definitely find a surgeon who would not amputate his nerve laden prepuce which provides protective, sensual, and sexual functions.

My decision is also based on all the millions and millions of infant boys in our country who have undergone unnecessary prepuce amputative surgeries for various reasons including so called "medical” reasons. What an American tragedy! Be grateful. You and his daddy are blessed to have a healthy child. Your son's "variance" is not really a problem unless you perceive it to be one. Best Regards & Many Blessings to you and your unique little boy.

[eepster]

In other countries that value the foreskin more, such as Sweden, some Drs try to save and even repair the foreskin during the hypospadia repair. Remember, this is not an emergency, and you have plenty of time to look at all options.

If he is not having difficult urinating, and the cordee doesn't cause him discomfort, the repair can be put off till adulthood, if you choose. Needing to sit isn't a difficulty, it simply is an embarrassment issue in the minds of the urologists (many men, including my DH who is too short to reach adult hight urinals, prefer peeing in stalls anyway.)

Most US urologist will give you the advice to fix it now, and to use the foreskin as graft tissue. Instead look for opinions from European Drs, and talk to adult men who have this condition.

ETA: link to info about foreskin preserving repair http://www.cirp.org/library/restoration/gray1/

[Ron_Low]

Two months and what actual medical situations have arisen?

If none, do nothing. HE is the best person to decide what risks and losses are worth which benefits.

I sit to pee 99% of the time and I'm as manly as I care to be. Even women when can pee standing up with a little training or a handy appliance if they want to. Google it.

[PuppyFluffer]

I've met Ron, he's pretty manly!

My dh sits to pee a great deal of the time too - makes cleaning the bathroom easier!

[tutucrazy]

My dad always sits to pee. :P Nothing wrong with that.

Others are right, if he can pee then do NOTHING until such a time comes when he can decide. Right now the only function his penis needs to do is urinate. Sexual functions can be fixed when he reaches sexual maturity.

We have one member that is VERY well researched about hypo on here. His name is perspective, but I have not seen him on in a while. I will try to put you in touch with him. He was circumcised as a baby due to his hypo and has done a great deal of in-depth research. He wishes that his mom would have left him alone until he was an adult. His twin brother was left intact.