Imagine a small boy of 5 years, who couldn’t perform one of the important human tasks. Suffering from a type of Hypospadias, Ram* didn’t have the ability to pass urine normally. If not treated, this condition could later in life lead to misdirected urinary stream and issues with sexual functions. The despaired family came to Kaka-Ba hospital in Hansot, seeking for a solution for their little boy.
Hypospadias is a condition present from birth in which the opening of a boy’s urethra, the tube that carries urine from the bladder out of the body, isn’t located at the tip of the penis. It may be located on the head of the penis, along the shaft, or on the scrotum, which is the sac that contains the testicles. 
There are multiple types of Hypospadias and is generally treatable through a minor surgery. However, Ram had the most severe type of Hypospadias – perineal hypospadias. A perineal hypospadias occurs when the urethra opening is behind the scrotal sac. These are the most severe forms of hypospadias and the least common. 
Ram was brought to Kaka-Ba hospital to Dr Mayur Lekhadia, a renowned plastic surgeon. On examination, the case got complicated. It was found that in addition to perineal hypospadias, the boy also suffered from penile hypoplasia and perineal tumour.
“Penile hypoplasia is when a boy has an abnormally small penis. Ram was then investigated with routine biochemistry, coagulation profile, USG of abdomen & pelvis and of tumour. An endocrinological work up was also done and all the tests were found out to be normal except for low Haemoglobin levels. He was first treated for that,” shared Dr Mayur.
After the initial round of check-ups, Dr Mayur first treated him for penile hypoplasia by hormone therapy. After adequate size of the penis was achieved, Dr Mayur focussed on the next challenge at hand. After a round of sonography, it was found out that the tumour was a lipoma tumour. The first stage of surgery was done by chordee release with tumour excision. The skin of the tumour was then applied as full thickness graft on ventral part of the penis generously. The graft taken up by the boy was extremely encouraging marking a success to the complicated procedure.
“After the catheter was removed post-surgery, Ram could pass urine from the tip of his penis. For the first time I felt like my kid would be able to live a normal life,” Ram’s father said.
His penis and scrotum shape and size are also healthy. Even though the procedure was quite complicated, the team of Kaka-Ba hospital could pull it off, providing an opportunity of leading a normal life to Ram.
*Name of the patient changed to protect the identity