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Originally Posted by maylea_moon  My son was born 4 days with a very mild form of Hypospadias (glanular). Pediatrician says he will need to be circ'd around 6 months in order to repair it? He says that if it's not repaired (they do use general anesthesia and some of the foreskin to repair it) then he could end up with infertility issues...
i'm torn and confused, anyone have a son with hypospadias that they DIDN'T have to circ?
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No, but I have a penis with hypospadias. I've had it all my life, along with my foreskin. Neither has caused me a moment's bother. (Well, not entirely true... I was celibate well into my 20's because of concern how each characteristic would be perceived, moreso the former than the latter. Turned out neither has ever been worth thinking about. But no health concerns.)
The idea that glanular hypospadias requires surgical repair is a direct holdover from the intersex hysteria of the 1970's, the belief that children need to be surgically corrected to meet the ideal of their gender. Ironically, the ideal for males means less than they're born with, but in any event it did seem that society and the medical profession in the US were finally getting away from this "cookie cutter" idea about genitalia and finally accepting that there is a spectrum of what's normal and healthy. And mild hypospadias is clearly within the norm for boys.
I'll add that I have seen several glanular hypospadias repairs, and I'll take what I've got over that, any day. They look like little episiotomy scars and wholly unnatural.
Doctors also seem to have a bizarre notion that the foreskin is just like a piece of spare cloth that you can nip and clip and even completely remove without consequence. The truth is that the foreskin is highly evolved and specialized, with some nerve endings running parallel to the shaft and some, particularly near the supremely innervated mucocutaneous junction, running perpendicular. That is also where much of the smooth muscle tissue is.
It doesn't take a PhD anatomist to understand that even nicking into this tissue severs some of the nerve function and much of the whorled, closing function of the infantile prepuce. It is a closed, interconnected system that is easily short-circuited by slicing into. Why most doctors don't "get" this instinctively is a troubling mystery. This system is intact even for boys with hypospadias. The muscle tissue may be aligned differently, but the nerves are certainly all there.
Some glanular hypospadias is so mild that it can be seen only by retracting the foreskin. My friend Kevin surprised the heck out of me when he mentioned that he has hypospadias, as I'd seen him nude at the pool shower and have come to know the "cowl"-like appearance of a typical hypospadic foreskin. I'm always interested in hypospadias and it wasn't exactly politic of me to ask, but I did and he showed me that there is no trace of hypospadias when his foreskin is down; in fact, it's long both in front and in back. But retracted, he looks just like me when I am. And neither of us has a frenulum, to speak of. My point is that the variants in human anatomy can be both extensive and normal.
As for damage to the foreskin from using "bits" of it to repair hypospadias, I can only rely on the experience of 2 close friends of mine. Both were having foreskin problems in their 20's within a few months of each other, for separate but understandable reasons. Both were told repeatedly that circumcision was the only option. But they did their homework, and each eventually found doctors willing to try a surgical repair. The one in San Diego opted for a Z-plasty with 3 incisions, and the friend in Seattle opted for a similar operation with 4 incisions. This procedure
removes no tissue, just makes nicks and then re-stitches the foreskin more loosely.
Even so, both friends reported dramatic loss of sensation, which has never fully come back. Once the ring of nerves and muscle tissue was compromised, the body had to re-wire itself. It hasn't been that big an impediment; both married their girlfriends and each now has 2 kids. But they remember what their foreskins were like before, and regret taking them for granted. Neither wishes he'd had a circumcision, but it makes me sad when the one friend refers to his foreskin now as his "overcoat".
Please research this thoroughly before deciding whether to put your little one through a surgery he really may not benefit from.
