Hypospadias Surgery in Lebanon — عملية الإحليل التحتي

What is Hypospadias Surgery in Lebanon?

Hypospadias is a congenital condition in boys where the opening of the urethra (the tube that carries urine) is located on the underside of the penis rather than at the tip. It is one of the most common birth defects affecting boys, occurring in approximately 1 in 200–300 live births. The condition varies in severity — from mild (distal) where the opening is near the tip, to severe (proximal) where it is closer to the scrotum. Hypospadias may also be associated with a downward curvature of the penis (chordee) and an incomplete foreskin.

Signs and Symptoms

Parents or pediatricians typically notice hypospadias at birth or during early examinations. Signs include: the urethral opening is not at the tip of the penis; an abnormal foreskin that appears hooded (covering the top but not the bottom); a downward curve of the penis (chordee); and in some cases, difficulty with the direction of the urine stream. In milder cases, the condition may not be immediately obvious and is sometimes identified later.

When to See a Pediatric Urologist

You should consult a pediatric urologist as soon as hypospadias is identified — ideally within the first few months of life. Early evaluation allows the surgeon to assess severity, plan the repair, and schedule surgery at the optimal time (typically between 6 and 18 months of age). Importantly, circumcision should NOT be performed on a child with hypospadias, as the foreskin tissue is often used during the surgical repair.

How Is It Diagnosed?

Diagnosis is clinical — made by physical examination at birth or during routine pediatric visits. No imaging is typically needed for isolated hypospadias. However, in cases of severe hypospadias (especially with undescended testes or ambiguous genitalia), additional tests including ultrasound, hormonal evaluation, and genetic studies may be recommended to rule out differences of sex development (DSD).

Treatment Options

Hypospadias is corrected through surgery, usually performed as a single-stage outpatient procedure between 6 and 18 months of age. The goals of surgery are threefold: straighten the penis if curved (orthoplasty), create a new urethral opening at the tip (urethroplasty), and reconstruct the foreskin or perform circumcision. Dr. Kallas Chemaly performs the full range of hypospadias repairs — from distal TIP (tubularized incised plate) procedures to complex proximal two-stage repairs. His fellowship training at Hôpital Robert-Debré (Paris), where he delivered a state-of-the-art lecture on hypospadias to the Hellenic Urology Association, provides families with access to world-class surgical expertise.

Dr. Kallas Chemaly's Approach

Dr. Kallas Chemaly takes a meticulous, patient-specific approach to hypospadias repair. He evaluates each child individually, explains every aspect of the procedure to parents in their preferred language (Arabic, French, or English), and uses the surgical technique best suited to the anatomy — not a one-size-fits-all approach. His European fellowship training at three centers of excellence means complex and redo cases are within his expertise. He believes the first surgery gives the best chance of success, which is why choosing an experienced pediatric urologist from the start matters.

References

• Stanford Medicine Children's Health: Hypospadias in Children
• Children's National Hospital: Pediatric Hypospadias
• MedlinePlus Medical Encyclopedia: Hypospadias