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Feedback from the parent of a child who had undergone successful Hypospadias surgery by Dr. Anand K Nagwani at Cosmo Aid Clinic Kolkata Dr. Anand Kumar Nagwani M.Ch. Plastic & Cosmetic Surgeon Dr. Anand Nagwani is the author of this website. He did his masters in surgery from BRA (Formerly Agra) University. He then his super specialization in cosmetic and plastic surgery and obtained M.Ch. degree from IPGME&R under West Bengal University of Health Science. From his long experience in cosmetic and plastic surgery and use of advanced Laser he says that “It is so important to feel confident when considering any cosmetic surgery. Confidence comes from asking questions and getting answers. While I attempt to answer those most frequently asked on this site, I am aware that nothing replaces a personal consultation for answers to personal concerns. One of the most important parts of my job is to listen carefully and I consider no question too small or unimportant. By listening to you, getting to know you and truly understanding your needs, I can perform the safest and most efficient procedures available, in accordance with your own personal goals. Etiology & Pathophysiology The condition is thought to be caused by under-stimulation of the genital tubercle and penis by dihydrotestosterone, resulting in failed fusion of the urogenital folds. However, deficiency or abnormality of testosterone, dihydrotestosterone or 5-α reductase is not commonly found in hypospadias alone. Direct aetiology is unknown in most cases and it appears to be a multifactorial process with links made to hormonal changes, genetic sus-ceptibility and environmental factors.Female sex hormones have been implicated and the ever increasing use of oestrogens has been suggested as a possible cause for the recent rise in incidence. In addition it is five times more common in boys born from IVF – possibly due to the effects of materal progesterone on 5-alpha reductase. Presentation The prominent presenting feature of hypospadias is the abnormal urethral opening. The external urethral meatus or opening is present on under surface of penis anywhere from the glans, shaft of the penis, to scrotum or perineum. Parents are usually complaints of soiling of cloths during urination. The foreskin looks abnormal (hooded prepuce). The penis is curved (chordee). Urinary stream is narrow (due to pin hole meatus or opening). Sometimes present with due to other anomalies like inguinal hernias and undescended testes. Indication Indication of treatment is functional, social, and cosmetic. Functional urinary stream is not straight/spray of urine/soiling of cloths sexual gratification and or infertly(due to functional region) in adult life Social Male child has difficulty in urination in standing position, if he does than his cloths become soil. Cosmetic Hypospadias is a congenital abnormality of the male external genitalia wherein the external urethral meatus is found to be abnormal position, may be on the shaft of the penis, the scrotum or the perineum. This is accompanied by abnormal curvature of the penis in around 15% of cases, inguinal hernias in 9% of cases and undescended testes in 9% of cases About the Clinic Calcutta Cosmo Aid Clinic is a specialist centre where consultancy services, cosmetic correction with laser and surgical procedures is done with passion and professionalism. Patients are treated with humanitarian touch. Their feeling is given highest priority. Ultimate goal of the clinic is to gain confidence and satisfaction of the patients. The clinic has both outdoor and indoor facilities for treatment. There are two operation theatres and 5 super specialty Lasers. The ambience in the clinic is so made that patients feel comfortable and grow confidence on their treatment. Dr. Anand Nagwani is the Chief Surgeon. Other specialists are Dr, Janki Nagwani and few others to assist them. The clinic is located on Harish Mukherjee Road, very close to SKM Hospital /Shambhu Nath Pandit Street intersection. You will appreciate our beautifully appointed furnishings, state-of-the-art technology and techniques, and warm & friendly staff,and uncommonly pleasant experience.