No Margin for Error: A Surgeon's Struggle Repairing Hypospadias

"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.

Author: Warren Snodgrass
Publisher: Oh Press
Published: 12/05/2023
Pages: 378
Binding Type: Hardcover
Weight: 1.48lbs
Size: 9.00h x 6.00w x 0.88d
ISBN: 9798989423507

About the Author
Snodgrass, Warren: - Dr Warren Snodgrass is an internationally renowned expert in hypospadias surgery and Co-Founder of the Hypospadias Specialty Center, the only center devoted exclusively to the repair of this common birth defect. He developed TIP, the most frequently used operation by surgeons worldwide to correct hypospadias. Then he created the STAG repair for more severe cases not suitable to TIP, subsequently evolving it into the STAC. These two operations, TIP and STAC, correct any type of hypospadias to transform the abnormal anatomy into a normal penis. The story of these repairs and the opening of the Hypospadias Specialty Center is told in his memoir, No Margin for Error: A Surgeon's Struggle Repairing Hypospadias.Dr Snodgrass is the most published and cited author on hypospadias surgery in history, with over 50 peer-reviewed medical articles on this subject, as well as numerous book chapters and his own textbook Hypospadiology. These works have been cited by others over 7000 times.He is also a forceful advocate for evidence-based surgery. That includes personal quality assurance for surgeons using what he calls the 3Ps: Prospective data collection, Periodic outcomes review, and Practice changes to get better. To increase public awareness of this common birth defect that few have heard of, Dr Snodgrass and his colleague Dr Nicol Bush established the non-profit Operation Happenis. They also launched Hypospadias Heroes Day every April 28th to celebrate patients, their parents, and loved ones affected by this condition, as well as the surgeons committed to repairing it better.Throughout his career Dr Snodgrass has been driven by the premise that all boys born with hypospadias want to grow into men with a normal penis.In addition to his medical work and writings, he also was intrigued by the backstory to the fall of the Berlin Wall. To learn more he taught himself German and then wrote Swords to Plowshares: The Fall of Communist Germany.When he is not working or writing, Dr Snodgrass enjoys weekends at the beach in Galveston, and vacations skiing and scuba diving.