No Margin for Error

"A Fascinating Account of Hypospadias Surgery." - a hypospadias mother

Every 90 seconds a boy is born somewhere in the world with hypospadias. That is more often than cleft lip or Down's syndrome or spina bifida, yet neither the parents nor grandparents have likely ever heard of hypospadias before - because it affects the penis. Most of these boys will have surgery to make the penis look and function normally. For many this will be successful, but others will have complications that can last a lifetime, and a few have such a severe problem that surgeons may despair of ever making things right.

In No Margin for Error, internationally renowned surgeon Dr. Warren Snodgrass tells his story of discovery and innovation working to improve hypospadias repair. His memoir begins in the operating room when he develops the TIP procedure, the operation that would soon be known worldwide as the "Snodgrass." The story continues with his search for the limits of TIP repair, and the best way to correct hypospadias when TIP cannot be done, while chronicling his success and failures teaching other surgeons what he was learning. Throughout this journey he is driven by the premise that every boy with hypospadias wants to grow into a man with a normal penis.

It is surprising to learn from this memoir that most surgeons do not know their own results for the operations they do. And that specialists may not do an operation often enough to get the best results. Because of this, and comments from his patients, Dr. Snodgrass gradually realized that treating hypospadias involves much more than refining surgical techniques. His story also describes:

• How hypospadias affects not only the patient, but everyone in his family.
• What happens when hypospadias is not repaired, or not repaired right.
• The 3Ps he advocates surgeons use to reduce complications.
• How difficult it is to raise public awareness about a birth defect of the penis.
• The need for specialized hypospadias care.

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