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Urology/Urethrocutaneous fistula/split glans

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Question
I'm a 30-something male, with distal hypospadias repair at age 4, using foreskin. Repair has left me with a minor urethral fistula, and a split glans, with the reconstructed urethral opening just below underneath. No problems with ejaculation, with urination, I have to cover the fistula with a finger to prevent drops of urine from dribbling out. My main concern is aesthetic appearance and also size (4.5").

Is surgery to close the fistula and attempt to restore normal appearance of the penis feasible at my age? Is any kind of enlargement possible?

Answer
Regarding size, penile enlargement surgery does not enlarge the penis in a normal way, and can be associated with very serious complications.  Beware!  Regarding your minor fistula, certainly this can be repaired.  My advice is that you see a Urologist with expertise in this surgery.  I believe that a doctor with the most expertise is an experienced Fellowship trained Urologist whose practice is 100% male urethral and penile surgery and not a Urologist who is an expert in male urethral and penile surgery and U, V, W, X, Y, and Z.  Which surgery would be best after prior surgery is best assessed with a physical exam.  Then, you should be counseled regarding the risks of surgery and what you should expect as the likely result so you can best decide whether to have surgery or not.   best of luck.  

Urology

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Joel Gelman, M.D.

Expertise

Urethral Stricture Disease, Peyronie's Disease and disorders of penile curvature, Erectile Dysfunction with a focus on penile implant surgery, Male Incontinence, Hypospadias

Experience

Dr. Gelman is a Board Certified Fellowship Trained expert in Male Reconstructive Urology and the Director of the Center for Reconstructive Urology in the Department of Urology at UC, Irvine Medical Center.

Organizations
American Urologic Association Society of GU Reconstructive Surgeons (Board of Directors) International Sexual Medicine Society Western Section, Americal Urological Association

Publications
Journal of Urology Urology Journal of Endourology

Education/Credentials
Residency in Urology, UCLA, completed 1995 Fellowship in GU Reconstruction, Devine Center, completed 1997

Past/Present Clients
The Center for Reconstructive Urology is a regional, national, and international Tertiary Referral Center for urethral stricture disease, penile curvature, erectile dysfunction, male incontinence, and other surgical disorders of the male urethra and penis. Patients have travelled from 24 different states and other countries to receive care at the Center for Reconstructive Urology. More information can be found at http://www.centerforreconstructiveurology.org

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