LAPAROSCOPY IN UROLOGY
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HYPOSPADIAS REPAIR - SINGLE STAGE
Normally the water passage (Urethra) extends from the bladder to the tip of the penis. In this condition the tube in the penis is not fully developed and therefore will not extend the full length of the penis. There may also be an associated bend in the penis.
This can be corrected in stages or as a single stage. We prefer to do this as a single stage procedure under magnification, because this gives the best results – avoid multiple operations, and hence is cheaper than multiple stage procedures – not to mention agony the child and parents can avoid from multiple surgeries. However, there are occasions when the problem is so severe, that multiple stages will be required.
The operation consists basically in reconstructing a tube from the skin – preferably foreskin, to extend the deficient water passage. Any bend in the penis is also corrected at the same time. Very many small sutures are applied under magnification to achieve this. If even one of these sutures, do not heal properly a fistula (leak from the tube) will develop. A single stage repair has the least chance of leak-5%, while a multi stage procedure or a second procedure is likely to have 30% leak.
Please arrange to have careful supervision of the child for 1-month. You will spend about 2 weeks in the hospital.
You may be advised to take some tablets before operation.
Pre-operative medical fitness would be assessed by me and the pediatrician before admission.
1. You should come at the appointed time, in the morning, on the date of admission.
2. Date and time of surgery will be informed at the time of admission.
DAY OF SURGERY
1. The surgery may be delayed by about an hour depending on the availability of the theatre.
2. Single stage repair lasts about 4 to 8 hours depending on the severity of the deformity.
3. The child will be in the postoperative intensive care unit on the day of surgery.
4. One care taker of the child's will often be permitted to sit with the child.
5. There will be a tube from the lower abdomen to drain urine directly from the bladder, allowing healing of the wound in the penis.
6. This tube will be maintained from 7 to 21 days depending on the healing of the operative wound.
1ST OPERATIVE DAY
2. SPECIAL CARE SHOULD BE TAKEN TO SEE THAT THE TUBE FROM THE BLADDER IS NOT BLOCKED IN ANY WAY.
5TH POST OPERATIVE DAY
1. The first change of dressing is done usually on the 2nd or 3rd postoperative day.
10TH POST OPERATIVE DAY
1. The catheter from the bladder is clamped usually on the 7th to 10th day.
2. The first passage of urine is painful.
3. If there is no leak and urine is flowing well the child will be observed for another 2 or 3 days before being allowed to go home.
1. Daily Sits bath is advised. The child will have to sit in medicated water for 10 minutes every day to soak the penis.
2. Out patient visit is required in about a week.