Talking about marriage and childbirth with male hypospadias

Talking about marriage and childbirth with male hypospadias

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Hot Topic 1: How to spot hypospadias

There are four types of hypospadias depending on the location of the opening of the urethra.

1. The head of the penis. Most commonly, the urethral opening is located in the frenulum.

2. Penis type. The urethral opening is located anywhere on the ventral side of the penis or the junction between the coronal sulcus and the scrotum.

3. Penile-scrotal type. The penis is severely deformed, short, flat, and curved downward. The head of the penis is even connected to the scrotal suture, and the urethra is small and located at the junction of the penis.

4. Perineal type. The development of the external genitalia is extremely abnormal, the penis is hypoplastic, highly curved, covered by a hood-like foreskin and a split scrotum, the entire external genitalia resembles a female, and the urethra opens in front of the anus, opening like a funnel.

The presence or absence of hypospadias can also be determined by self-examination. Hypospadias is diagnosed if the penis has any of the following deformities:

① Abnormal opening of the urethra;

②The penis is flexed to the ventral side;

③The foreskin on the dorsal side of the penis is long and wraps the head of the penis, while the foreskin on the ventral side of the penis is lacking;

④ There is a band from the head of the penis to the opening of the urethra, which is the reason for the flexion of the penis to the ventral side.

Hot Topic 2: Does It Affect Marriage and Childbirth?

Hypospadias, especially in patients with penile-scrotal and perineal types, if not treated, will not only affect marriage and childbirth, but also bring serious psychological contusion.

Severe perineal hypospadias is called "false vagina" in medicine. Such patients are prone to gender errors. Some people are mistaken for women at birth, raised as girls from childhood, and only realize that they are men when they are adults. Another example is patients with severe hypospadias, who cannot stand like normal men when urinating, and must use a sitting or squatting position. In childhood, he will be ridiculed and will have a psychological barrier, and when he grows up, he will not dare to take a bath in a public bathroom or show nakedness. Therefore, patients should go to the hospital for surgical correction before school age.

If it is delayed until adulthood due to various reasons, physical defects and psychological shadows will have a certain impact on marriage and childbirth. Some patients are so worried about their sexual organs that they have sexual dysfunction, and even avoid women intentionally; some patients will have a certain impact on the erectile function of their penis, or although the penis can erect, it is obviously curved or painful during erection. Some patients can barely complete their sexual life after marriage, but because of the abnormal opening of the urethra, semen cannot be discharged into the female reproductive tract, resulting in infertility.

Therefore, if hypospadias are found before marriage, they should go to the hospital for surgical treatment. Those who are confused by gender must be identified by a doctor before they can get married.

Hot Topic 3: Can I get married and have children after surgery?

There are more than 200 surgical methods to correct hypospadias, but the purpose is the same. One is to straighten the penis, and the other is to repair the urethral opening to the head of the penis. Surgery is successful in most patients. However, 10% to 20% of patients are also accompanied by other malformations of the urogenital tract, such as cryptorchidism, congenital anomalies of the kidneys, etc., which doctors must consider together; some people have mixed genders, and doctors must also carefully distinguish them.

After the operation is successful, if the patient's sexual function is normal, the testicles can also produce normal sperm, and can be smoothly excreted, then marriage and childbirth will not be a problem.

Hot Topic 4: Does a Short Penis Affect Sexual Life?

Hypospadias patients due to penile dysplasia, the penis is inevitably short after surgery, so some people worry that the penis will not affect the sex life after marriage? This issue should be discussed separately.

There is indeed a very rare "small penis" disease in medicine. In addition to the small penis, patients often have small testicles. Some people have no testicles in the scrotum, which is cryptorchidism. The secondary sexual characteristics are not well developed. No nocturnal emission. After such a patient gets married, sexual life and fertility will be affected.

And many people's so-called short penis is just an individual difference, not a disease. Moreover, the penis of the short penis will increase significantly after erection, and the sex life will not be affected after marriage, and fertility will not be a problem. However, some people worry too much about the small penis and form a mental burden, which leads to sexual dysfunction, which will affect their sexual life.

The ability to have children after hypospadias depends on whether the testicles can produce sperm normally and transport them outside the body. If testicular atrophy has been caused by cryptorchidism or testicular hypoplasia, fertility may be affected. Therefore, those who have not given birth after one year of marriage should go to the hospital for semen analysis and other tests to clarify the cause and take measures.

Text/Deputy Chief Physician Ouyang Jun

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