Chordee, hypospadias, and penile torsion in babies 

Chordee, hypospadias, and penile torsion are some commonly occurring problems in baby boys. These are commonly seen to occur together, but they can also occur separately. At ALSA Pakistan, our child surgeon Dr. Muhammad Mohsin performs penile surgery in baby boys for the treatment of chordee, hypospadias, penile torsion and undescended testicles treatment . Let's take a detailed look into these conditions and their treatments;

What is chordee?

Chordee is a condition that occurs in baby boys in which the shape of your baby's penis sharply curves upwards or downwards, appearing bent or curved.

It is a congenital condition which means your baby can be born with it. It can be noticed at the time of birth and needs to be corrected timely. At ALSA, Dr. Muhammad Mohsin performs penile surgery in baby boys for chordee repair in Pakistan.

Causes of chordee

The exact cause of chordee is not known. The most common reason is that it occurs as a result of abnormal development of the penis in the womb. Skin defects, penis abnormality, or scar tissue can also lead to the development of chordee even later in life. Chordee can occur as a stand-alone medical condition or in association with hypospadias and penile torsion. Additional techniques are used for penile surgery in baby boys to treat chordee with hypospadias and penile torsion.  

Penile surgery in baby boys for chordee repair in Pakistan by Dr. Muhammad Mohsin

Surgery to treat chordee At ALSA Pakistan is a standard and very successful choice. Surgery is preferably performed before the age of 2; the ideal time is between 4 to 8 months because the treatment of chordee in older boys or adults can be more complicated that may require multiple surgical procedures.

The procedure takes about 60-120 minutes depending upon the severity of the chordee, and commonly the child is able to go home the same day. The aim of the surgery is to straighten the penis. Any excess skin is removed during the surgery; it is called degloving. We perform an erection test using saline solution to ensure the penis is no longer curve. Usually, the baby has a very smooth recovery after chordee surgery and can have a fully functional, straight, and normal penis within a few days.

Hypospadias in baby boys

Hypospadias is a birth defect in newborns in which the opening for urination (called meatus) is not at the tip of the penis. There are different degrees of severity in hypospadias, some can be minor, and some can be more severe and need surgical repair. When hypospadias is discovered in a baby, surgery can be performed when the baby is a few months old.

Types of hypospadias 

The types of hypospadias depend upon the location of the opening of the urethra (the tube that transfers urine from the urinary bladder to the outside of the body);

  • Subcoronal hypospadias; the opening is located somewhere near the head of the penis.
  • Midshaft; the opening is located along the shaft of the penis.
  • Penoscrotal; the opening is present where the penis & scrotum meet.
  • Perineal; opening is behind the scrotal sac.

Hypospadias can occur alone, or it can also occur with chordee and penile torsion. Boys with hypospadias face problems such as spraying of urine, or they might have to sit down to urinate. Hypospadias complications are associated with fertility problems later in life. Penile surgery in baby boys is performed to treat hypospadias by relocating the opening for urination.

penile surgery in baby boys

Hypospadias surgery in Pakistan 

Most cases of hypospadias need surgical repair. Ideally, we perform hypospadias repair at the age of 6-12 months. The aim of the surgery is to place the opening for urination in the right place and close the malformed opening. If chordee and penile torsion are also diagnosed with hypospadias, we can treat them as well during the penile surgery in baby boys.

In the case of hypospadias with chordee, we firstly straighten the penis (correcting chordee) and create an extension of the urethra, bringing it to the tip of the penis. We use penile skin tissue to create a new urethral pathway for urination. 

After the surgery, the baby may need a catheter for a few days to urinate. Usually, the baby can go home the same day after the surgery. 

Penile torsion in newborns 

It is a condition in which the penis of the baby appears to be rotated or twisted almost always towards the left (counterclockwise). Male infants with this defect are born with it, and it is fairly common. It can range from mild rotation to severe and occurs in about 1 in 80 newborn babies.

It occurs when the skin and tissues of the penis do not develop properly in the womb; however, the specific cause of penile torsion is not known. Usually, penile torsion does not cause other symptoms, especially when the rotation is less than 90 degrees.

Surgery for penile torsion 

Surgery for penile torsion is needed when the rotation of the penis is more than 90 degrees. There are different techniques that are used to treat penile torsion. The most common technique is called degloving, in which we perform subsequent repositioning of penile skin to treat the rotation of the penis. Penile torsion surgery is ideally done at the age of 6-18 months.

Penile surgery in baby boys is generally very successful, especially when performed at the right time. If the surgery is delayed until adulthood, it is still effective, but multiple surgeries can be required. At ALSA Pakistan, our child surgeon Dr. Muhammad Mohsin is highly experienced in performing penile surgery in baby boys to treat different types of defects.