Hypospadias letter template

Issue - Hypospadias Thank you for asking me to see John Doe. He is a healthy 6-month-old boy with hypospadias, brought in by his parents, Jane and Richard Doe, this morning. On examination, Meatus: Located on the ventral side of the penis. Glans: Slightly underdeveloped. Shaft: Mild curvature noted. Chordee: Present. Testes: Both descended and normal. Hypospadias occurs 1 in 250 boys, and there is a spectrum. There is likely a hormonal influence, although occasionally inherited and/or associated with other syndromes. Principles of repair were discussed: Straight shaft, straight stream, adult function, and psychological well-being. Timing of repair revolves around toilet training, school age, and the decision to allow John to choose for himself in the future. Repair is not mandatory for all boys with hypospadias, and largely revolves around penile function. Depending on how much reconstruction is required, it usually involves a day procedure under general anaesthetic. The foreskin can either be removed or reconstructed. Risks of surgery include bleeding, bruising, infection, and swelling. For this procedure, there is a possibility of narrowing, leak (fistula) from the reconstruction, or breakdown of the repair. There is about a 20-30% chance of requiring further surgery. This could be in the first 2 years or potentially around puberty when the scar tissue may not grow with penile growth. Anaesthetic risk includes airway concerns and allergic response. This is discussed more formally by the anaesthetist. For now, John is still growing. I'd like to catch up in 6-8 months before considering repair. We'll talk further at the time.