A successful repair
When I sat down to write this post after a long hiatus, I couldn’t think of the right title. Among those most fitting was “Ha-lle-lu-jah”. I settled on one that’s descriptive if you’re just jumping in to this blog and included what made it possible.
A successful penoscrotal hypospadias repair:
faith, love — and an amazing surgeon
I couldn’t blog for awhile. I wanted to be confident of where we were, and that we’d stay there. When we left off we were waiting for the stream to come. And as much as we waited, and prayed, the stream didn’t eventually come. Emmett continued to strain and was increasingly unable to rest. We took a video and sent it to our surgeon. He suggested we scan his bladder to ensure he wasn’t retaining.
If you’ve ever scanned your child’s bladder, you know it’s relatively quick. They hold a wand over the bladder just long enough for a reading. Once the nurse got the reading, she began grabbing catheters and calling for a urologist. Emmett had 120 ccs in his bladder. Distended, his bladder can hold about 180 ccs. So 120 was pretty full. My husband sent me to the waiting room while he and grandma held Emmett down. Two urologists tried to catheterize him but neither could get one in.
We were sent to the hospital where we would be met by one of the urologists to catheterize him under anesthesia. If they couldn’t get a catheter in while he was under, they’d put another SP tube in. An 8 fr catheter was successfully placed under anesthesia. When the doctor met us in the waiting room, she told us how good the repair looked and, consistent with the opinion of others who’d scoped him, said she believed the issue was inflammation at the tip. It was a few days from Thanksgiving and we left the hospital with a new catheter, and new faith that when we removed it, this would be it.
The catheter was in for 17 days. Our local urologists had decided they would no longer remove Emmett’s catheters. Understandably, since they didn’t specialize in pediatrics and were nervous going forward with our track record. We needed a state-level pediatric urologist in our court. We couldn’t be seen by OHSU Doernbecher so our pediatrician sent a referral to children’s hospitals in both Seattle and Portland. Our insurance denied the first since they won’t cover out-of-state providers, and the second declined due to the perceived complexity. Our pediatrician contacted OHSU Doernbecher and asked if they would see Emmett. Thankfully, they agreed to help.
The catheter was removed on a Wednesday. It had been in for 17 days. He was put on a few day course of Valium and back on Flowmax for a few weeks — the Valium to relax his body and the Flomax to relax his urethra. We were parked in one of the RV spots at the hospital and had planned on staying a few days to monitor him.
[This part will make you smile] Guess what happened next? Emmett made wet diapers — and kept making them. Every day or so, we’d remove the diaper and try to ‘catch a stream’, and while the first couple days weren’t picture perfect, they were good enough considering everything was brand new. On Friday his bladder was scanned at the hospital and was completely empty. It took effort for us not to get too excited; we were pretty ecstatic. We went home on Saturday with a checkup scheduled for 6 weeks. On Saturday evening, Emmett stood naked on the couch watching his favorite movie, and he peed .. a stream. A real, perfect and uninterrupted stream. He didn’t strain, push or dribble. He just stood there and peed. Can you guess what I did? I know I said I would pass out with joy, and while I nearly did, I cried (well, bawled actually), and began calling grandparents, squealing through the phone, “He peed!!! …” It was a pretty amazing moment.
Over the course of the next four weeks, Emmett perfected his stream. In fact, yesterday I watched him stand there like that classic image of two boys, side-by-side, seeing who can pee the farthest. It was rounded and strong, straight and far. It’s amazing how something seemingly so insignificant we take for granted, like the ability to pee, can become everything.
After our checkup in two weeks we’ll start tapering off the Flowmax. Based on how amazing Emmett’s doing, we believe he’ll do great. He’s also began sleeping through the night, peacefully and in his own bed. His morning diapers are so full that they seep out into his PJs — and we couldn’t be more elated. My husband says we went from a nightmare to a dream, overnight.
Penoscrotal hypospadias repair is a complicated thing. We chose the best surgeon for our child with what ended up being a two-stage repair, with just some stubborn inflammation that healed with a beautiful blessing. Upon scoping him 4 months after the second stage, there was no scar tissue. His foreskin is in tact and its original, hooded appearance has been artfully reconstructed. There is no residual chordee, even with an erection. There’s nothing I could do to thank Dr. Snodgrass enough (and my father for gracefully helping us pay the way) for allowing our little one to pee.
PS. If your child has proximal hypospadias and you’d like to see our before and after pictures, just email me.
Love to you, Christina