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180 boys on waiting list

Colombian urologist arrives to perform specialised surgeries...

By \\\\\ Sue-Ann Wayow sue-ann.wayow@trinidadexpress.com

THERE are more than 180 boys with abnormal penises and who are waiting, some as long as three years, to have special surgery performed to have the problem rectified.
For this reason, the South West Regional Health Authority (SWRHA) has engaged the services of Dr Victor Figueroa, a paediatric urologist from Colombia, to perform some surgeries.
On Thursday, the SWRHA hosted a hypospadias workshop at Royal Hotel in San Fernando, with Figueroa as the main speaker.
Hypospadias is a condition in  which the opening of the urethra is on the underside of the penis instead of at the tip.
The urethra is the tube through which urine drains from the bladder to exit the body.
It is painless but very uncomfortable when urinating, the Express was told.
SWRHA chief executive officer Anil Gosine said since Figueroa arrived in Trinidad on Monday, he has performed ten surgeries at San Fernando General Hospital.
Figueroa leaves today for Colombia.
Gosine said there were more than 100 patients at the SWRHA waiting to get the surgery done.
There is only one qualified surgeon in the public health sector to perform surgeries for hypospadias.
Dr Barbara Rampersad is the country’s only paediatric urologist and is based at the Eric Williams’ Medical Sciences Complex in Mt Hope. 
Gosine said, “In Trinidad, it is difficult to get surgeons to specialise in this area. We have brought down Dr Figueroa. He will carry out some surgeries...our surgeons will be around and they will learn some of the techniques. It is a very specialised area and you get better as you do more surgeries. Also we invited other paediatric surgeons to come and view and learn from Dr Figueroa.”
Figueroa told the Express, because of the complexity of the cases, not more than two surgeries could have been performed per day.
Each procedure takes about four hours, he said.
He said he had no problem working with personnel from the SWRHA and would like to return to complete the procedures.
“That is just the first operation. They need a second. There is a second stage to close everything up, so hopefully I will be able to come in six months, which is the time that we have to wait to finish the operation,” he said.
Rampersad said, “Hypospadias  is not a straightforward operation. It is a congenital condition and it is very common in Trinidad. Some parents don’t know this condition exists until their child is born because they have never heard of it. The oldest patient we have is probably close to ten years. I returned to Trinidad in 2005 and there was quite a long waiting list so I inherited some of these patients.”
Rampersad suggested having similar workshops and training more surgeons.
“It is not a simple operation. It is a very highly-skilled operation that requires a lot of training. You need one of two surgeons who are well trained to do it to get a better result. At the end of the day you don’t want the child to end up with an operation but then many operations to fix it.”

 



INCIDENCES AROUND THE WORLD:

 n Hypospadias are among the most common birth defects of the male genitalia, but widely varying incidences have been reported from different countries, from as low as 1 in 4,000 to as high as 1 in 125 boys.
Due to variations in the reporting requirements of different national 
databases, data from such registries cannot be used to accurately 
determine either incidence of 
hypospadias or geographical variations in its occurrences.
The incidence of hypospadias around the world has been increasing in recent decades. In the United States, two surveillance studies reported that the incidence had increased from about  1 in 500 total births (1 in 250 boys) in the 1970s to 1 in 250 total births (1 in 125 boys) in the 1990s. Although a slight worldwide increase in hypospadias was reported in the 1980s, studies in different countries and regions have yielded conflicting 
results and some registries have 
reported decreases.  
                                          —Source Wikipedia
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