Hypospadias advice

[Evandy]

I'm not sure that this belongs on this forum, but the issues are so similar, so here goes!

I am on a parenting listserve, and one of the moms posted asking for advice. Her 10-mo son has just been diagnosed with "very mild hypospadias." Her doc is advising her to get surgery (of course), although function is not affected. He (the doc) admits it is a cosmetic procedure, but 95% of parents choose the sx b/c of cosmetic reasons and to get a proper arc to the urine stream(!). This isn't one where she can leave the decision for him to make later; she says they only do the sx up to 18 months of age. She is planning on getting a second opinion.

Here is the response I plan on posting. Anything I'm missing? I'd just hate this little guy to have to go through surgery for nothing.

I’m sorry this is something you’re dealing with. Parenting is difficult enough without these roadblocks. I don’t have personal experience with this issue, but would like to offer my personal opinion. The hypospadias is very mild. It took ten months for anyone to notice it. Function is not affected. Any surgical procedure comes with risks, even routine procedures. I just feel like, if it’s not broke, don’t fix it. You would be putting your son at unnecessary risk. As far as cosmetic issues later, I seriously doubt that other boys will be scrutinizing his urethra placement in the locker room, and it sounds like close inspection would be necessary to detect this! As an adult, any woman who took issue would probably be too shallow for him to want to keep around, anyway. I guess it just seems like essentially cosmetic surgery is a risk not worth taking. Just my two cents.

Good luck!

Thanks for your help!

[GISDiva]

My son also has a very mild case.  (Although our midwife saw it right away at birth. ;) )  We talked to a urologist (we were there for other kidney-related reasons) and he looked at us and said "You seem like an "if it ain't broke, don't fix it" type of parents.  Doing nothing is a perfectly viable option."  So that's what we did.  He made no mention of the age-limit however.  I seem to recall that DS could decide to fix it whenever he liked later if he so chose.  I wanted to give him that choice.

I mean, he's going to get teased for still having his foreskin anyway, so... ;)

[Evandy]

I mean, he's going to get teased for still having his foreskin anyway, so... ;)

LOL!!

[Ron_Low]

As a male subjected to cosmetic surgery I would have preferred to have weighed in on, I urge you to please speak vigorously for that boy's right to make his own choices. 

-Ron

[MyBoysBlue]

http://www.drmomma.org/2010/04/hypospadias-surgery-and-circumcision.html

This is a great link on the subject with an intactivist view.

[Evandy]

Ron, I totally agree. This decision should be left to him! MyBoysBlue, thanks for the link. Reading this, it seems like the doc misinformed her about when the sx could be done. I'll definitely put something in there about waiting and letting him decide for himself whether cosmetic surgery is warranted and include the link. I don't know this woman, and most of the folks on this listserve are pretty mainstream, so I wanted to avoid coming off as too extreme.

[Greg B]

I think your advice is good.  The only things I would add are to focus more on the specific issues and press the doctor and any second opinion doctors on these issues.  the issues that I see needing more clarity on are:

1) How is he urinating?  If he is urinating fine, and the foreskin is helping to direct flow, then it sounds like he needs no surgery, and the risk averse decision is to do nothing.  Pressing the doctor on this point and the likely hood of future problems if surgery is or is not performed would be helpful.

2) Why is there a time limit?  what is gained by doing it now, rather than later?  What is lost by waiting?  She needs to really push on this issue.  My guess is that The doctor simply prefers to operate on infants, perhaps because it is easier or less stitches, or he himself has trouble dealing with this surgery on an adult.  If there is no real time limit, then again, waiting is the risk averse decision.

3)  Ejaculating.  My guess is that if it is mild, there is not problem with this issue either, and waiting is the risk averse decision.  But she should press the doctor on this point as well.  Advantages and disadvantage to waiting?

Regards