How should hypospadias in children be treated?

Patient's question:

Congenital hypospadias

Doctor's answer:

Hypospadias is a congenital pediatric urogenital disorder characterized by the urethral meatus not being located at the tip of the glans, and abnormal fibrotic tissue on the ventral side of the penis causing curvature, making it unable to stand straight during erection. In mild cases, it may only affect appearance, but in severe cases, it may require squatting to urinate and inability to achieve normal erection. The only treatment for hypospadias is surgery.
Currently, the trend is to perform surgery at an early stage. In plastic surgery, the procedure can be done as early as six months of age, and it is hoped that the surgery will not be delayed until after the child starts kindergarten to avoid psychological impact on the child. The surgical approach is divided into one or two stages based on the severity of the condition. After successful surgery, future sexual life and ejaculation should be problem-free, and fertility should be the same as that of the general population.
There are over 150 different techniques for hypospadias repair surgery, which can be completed in one or two stages depending on the severity of the condition. In a single-stage procedure, fibrotic tissue is removed to straighten the penis, and a new urethra is created. If done in two stages, fibrotic tissue is removed first, followed by a second-stage urethral reconstruction. After surgery, some patients may develop leaks in the newly created urethra, which can be repaired with additional surgery. In recent years, it has become feasible to move the urethral meatus forward to the tip of the glans, meeting aesthetic requirements.