Parent & Patient Information System 06/09/2015 Page36 / 51 It is treated by several surgical methods. The choice of method depends on the severity of disease and history of previous surgical interventions. All the methods aim to bring the hypospadiac meatus to the tip of the penis by creating a tube over a catheter. The prepucium is an important material used for reconstruction in these operations. Therefore, boys who have been diagnosed as hypospadias should not be circumcised before the operation. The optimum age for hypospadias surgery is between 6-18 months. The surgery can be planned in one or two sessions depending on the features of the disease. Postoperative complications may develop in 5-15% of cases. These percentages vary regarding the severity of disease and history of previous interventions. These complications are narrowing of the new created meatus, urine leakage from the incision line (fistula), wound dehiscence, wound infection, narrowing in the tube and the persistence of penile deviation. Micropenis Micropenis, is the penis which has smaller in length and circumference when compared to his age-matched counterparts in the same population. The averages of these measurement may change regarding the race, geographic area, age and inherently. There are tables or nomograms for each population. If the child’s penile measurements are below 2 standard deviations from the mean measurement on these nomograms, it can be considered as micropenis. It is hypothesized that the hormonal abnormalities occurring after 14th weeks of gestation causes this developmental problem. These problems are usually part of syndromes which may cause resultant additional diseases. Therefore, the children with micropenis should also be investigated for additional abnormalities. The diagnosis is made by measuring both the length and circumference of the penis. The measurement is done from the root of penis (penopubic junction) to the tip by stretching the penis. As the diagnosis is confirmed, patient should be consulted to a pediatric endocrinologist who will make additional tests such as caryotype analysis and hormonal tests. In most of the instances, the underlying problem is hormonal deficiency or abnormalities. Thus, hormonal replacement therapies are the most preferred modalities. However, there are controversies and concerns on the hormonal treatment on both the possible effect of hormones on bones which may end-up with early maturation and short stature and the timing and duration of
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