Hypospadias

Yesterday I took Jude to the pediatric urologist up at A.I. DuPont Children's Hospital.

Let me start by saying I've never been to A.I. but Ryan had been there quite a bit when he was a child. He was treated for hip problems and asthma there and had told me before how great of a hospital it was. In addition my younger brother Chad had been there previously for thrush. Again, my parents had told me how great the hospital was. Just pulling in the parking lot I could see why!

Out front is a HUGE fenced in play ground and signs for "free valet parking" (I didn't use the parking service, but nice to know it's there!). The surprises only got better as I walked in the door. They had a corral of baby wagons waiting in the lobby so you could load all the kiddies up and wheel them around.

When I went to meet the front desk to find out where I was supposed to go, so told me I needed to follow the signs for the "sunshine module". All of the areas were color coded in bright primary colors; it was precious.

Once I found the sunshine module I did a very brief check in - they had gotten most of my information over the phone when I called in to make the appointment. This was convenient compared to other offices because obviously with a baby in your arms, the last thing you want to do is juggle 10 pages of paperwork and a fussy child.

Not to mention everyone I talked to seemed to really enjoy what they do. They were all super friendly and eager to help in any way they could.

But now on to the reason for this blog: hypospadias.

Hypospadias is basically a fancy word for "off center pee-pee hole". Instead of the hole being at the tip it's off center and usually somewhere else along the shaft of the penis. Sometimes this can be as bad as all the way down towards the testicles, other times it can be as simple as being just slightly off center. Jude's is just slightly off center. It's so slight that the person doing the circumcision didn't notice it until she started the incision. Because she started the incision she had to stitch him back up. Basically the doctor performing the correction will need to use the foreskin to correct the problem and so continuing the circumcision would cause more problems.

The biggest problems associated with a hypospadias from what I gathered are the following:

1. Possible reproductive issues.

2. Instead of peeing a nice straight stream he'll do more of a 'spray'. Typically if you don't correct the problem the child can sit down to pee, but generally that causes developmental issues. For example a first grader not understanding why all his friends stand up. He could think something's wrong with himself - or worse people could make fun of him.

As of right now though, it's fine because he's in a diaper.

When I went in for the appointment the doctor insisted he see Jude pee (makes sense). I stripped him down and he stimulated him enough to get a stream. He said at this point with the stitches still healing, he couldn't really see the hypospadias, so needed to have him come back in 4 weeks.

In the mean time he told us to frequently try to get him to pee without a diaper on so that we can see it (don't most parents try to AVOID this?). Basically he said we want to make sure the stitches and foreskin are healing fine and not constricting the penis. He said it's not uncommon for the opening to close up a little making peeing painful and causing a "ballooning" of the foreskin (great!). He said he doesn't see this happening with Jude as the stitches are already almost healed and he seems to be peeing fine.

In addition he said that we need to rub A&D ointment on the little guy to help avoid the problem above. I told Ryan this was his job - as all things penis should be.

So, we'll be going back in a few weeks for a follow up. He said that typically what will happen once he confirms the hypospadias is that he'll need to go in for surgery around 6 months of age. he will need to be put under and they will correct the problem then. Correcting the problem includes basically poking a new hole in his penis and sealing up the old one. In my opinion it sounds super painful. I feel terrible for the little man.

But in the end, it was reassuring knowing that everything is healing fine and that we really won't have to worry about it again until November.