Over three years ago, paediatric surgeon Dr Manohar Tule presented 4,500 case studies of hypospadias – a penile defect among male newborns – during a national conference of paediatric surgeons at Aurangabad. At 73, the child specialist continues to perform around seven hypospadias surgeries every month on kids from across the country as well as border.
“Hypospadias is a condition where the opening of urine tube (urethra) is formed much before the tip of penis. This makes urine passage by the patient just like that by a female genital system,” said Dr Tule.
A mentee of renowned Australian surgeon Durham Smith, who pioneered hypospadias surgeries, Dr Tule has been conducting the corrective procedure after his first in 1982. “My first patient is now 40. He is a music teacher and has got married. Though it is not exactly established that it is a genetic defect, his son too suffered from hypospadias. It was corrected in two surgeries,” said Dr Tule.
Dr Nitin Turaskar, surgeon and former IMA president of Bhandara, said, “He (Dr Tule) has performed nearly 5,000 hypospadias surgeries with near perfection. This is the highest in the world. Still, he can perform surgeries up to 10 hours a day. You name a paediatric surgery and he has a long list of patients to his credit.”
Medical literature says one in 10,000 newborn boys suffers from hypospadias. “I keep getting patients on a regular basis. Kids from Pakistan too are referred to me,” said Dr Tule.
Earlier, corrective surgeries used to be done only after the age of 10. Now, they are recommended right after birth. “Parents often face this dilemma of determining the gender of their child. It is confirmed by detection of testicles, which too sometimes remain in abdomen. Ultimately, genetics help determine the gender. But I feel in today’s scenario, the defect should be corrected before kid starts going to school,” he said.
Revelation of the deformity can cause severe psychological impact on school going kids. “At school, boys often compete as to who can urinate the farthest. Hypospadias patients are forced to sit and pass urine. Some stop going to toilet at school. They develop a complex,” said Dr Tule.
As the surgery involves a lot of intricacies and results are not guaranteed, many surgeons do not prefer to do hypospadias surgery. “Parents have only one question — whether he will be normal. Many kids turn spoiled hypospadias cases and never get relief. We call it hypospadias cripple. It becomes very difficult to correct them,” said Dr Tule.
Recently, an army officer’s son had six unsuccessful hypospadias surgeries, including one at a premier institute in Delhi. “His son required two surgeries for correction,” he said.
Source: Health world.com
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