• Hypospadias Repair


    This surgery is used to treat a condition called hypospadias . This condition affects the penis and urethra. The urethra is the tube that connects the bladder to the outside of the body so that urine can exit. With hypospadias, the opening of the urethra develops on the underside of the penis. The goal of surgery is to put the opening of the urethra at the tip of the penis.
    The Male Reproductive System
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    Reasons for Procedure

    The surgery is done on male children born with hypospadias. Some males will not have problems from hypospadias. In some, the condition may make it difficult for the child to urinate while standing. It may also affect sexual function.
    The surgery is typically done at age 3-18 months old. It can also be done in older children and adults. In infants with hypospadias, circumcision should not be done. Tissue from the foreskin may be used if surgery is done to correct the hypospadias.

    Possible Complications

    Complications may occur after hypospadias surgery. The further the opening is from the tip of the penis, the higher the complication rate. If your child is having hypospadias surgery, the doctor will review a list of possible complications, which may include:
    • A new opening on the underside of the penis called a fistula, causing urine leakage
    • Scarring/narrowing of the urethra that makes it difficult to urinate
    • Alterations in sensation of the penis
    • Need for more surgery
    • Bleeding
    • Reaction to the anesthesia
    • Infection—wound infection or urinary tract infection
    • Psychological trauma
    Discuss these risks with the doctor before the surgery.

    What to Expect

    Prior to Procedure

    The doctor may do the following:
    • Physical exam
    • Imaging, blood, and urine tests
    • Discuss the anesthesia being used and the potential risks
    Talk to the doctor about your child’s medications and supplements. Your child may need to stop certain medications before the surgery. The doctor may also ask that your child take certain medications to prepare for surgery.
    Your child will need to have an empty stomach before the procedure. Ask the doctor when your child will need to stop eating.


    General anesthesia is used during surgery. This will keep your child asleep and block any pain.

    Description of Procedure

    This is usually done in an outpatient setting. Your child will not need to stay in the hospital overnight.
    Your child will be prepared for surgery. IVs will be placed in his arms for medications and fluids. Several techniques may be used to reconstruct the urethra. The doctor will attempt to use existing urethral tissue to:
    • Divert the tube to the correct position
    • Widen the tube if needed
    Tissue may be taken from the foreskin or mouth to reconstruct the urethra. Incisions and graft procedures may also be needed to loosen certain areas of tissue to straighten the penis or correct other problems. A temporary catheter or stent may be placed in the penis for up to 2 weeks. This will allow your child to urinate. Bandages will be placed around the penis.
    More complex cases may require a two-stage surgery approach.

    How Long Will It Take?

    1½ to 3 hours

    How Much Will It Hurt?

    Your child will be asleep during surgery. He will not feel any pain. After the procedure, the doctor will give your child pain medication.

    Post-procedure Care

    At the Care Center
    The staff will provide care to make your child more comfortable and promote recovery. Pain medications and antibiotics may be given. Swelling at the surgery area is normal.
    During your stay, the hospital staff will take steps to reduce your child's chance of infection such as:
    • Washing their hands
    • Wearing gloves or masks
    • Keeping your child's incisions covered
    There are also steps you can take to reduce your child's chances of infection such as:
    • Washing your hands and your child's hands often and reminding visitors and healthcare providers to do the same
    • Reminding your child's healthcare providers to wear gloves or masks
    • Not allowing others to touch your child's incisions
    At Home
    When your child returns home, do the following to help ensure a smooth recovery:
    • Encourage light, gentle play while the penis is healing.
    • Follow all of the doctor’s instructions.

    Call Your Child’s Doctor

    After arriving home, contact the doctor if your child has any of the following:
    • Pain that is not controlled with medication given
    • Redness, increased swelling, or tenderness in the penis
    • Signs of infection, including fever and chills
    • Nausea or vomiting
    • Inability to eat or drink
    • Difficulty urinating or cannot urinate
    • Catheter or stitches fall out
    In case of an emergency, call for medical help right away.


    American Urological Association http://www.auanet.org

    Healthy Children—American Academy of Pediatrics http://www.healthychildren.org


    Canadian Urological Association http://www.cua.org

    Health Canada http://www.hc-sc.gc.ca


    Canning DA. Can we correct hypospadias with a staged operation? If not, are we bold enough to report it? J Urol. 2015 Aug;194(2):284-285.

    Hypospadias. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated May 14, 2015. Accessed November 18, 2015.

    Hypospadias/chordee. Cincinnati Children’s Hospital website. Available at: http://www.cincinnatichildrens.org/health/info/urinary/diagnose/hypospadias.htm. Updated June 2013. Accessed November 28, 2015.

    Schlomer B, Breyer B, et al. Do adult men with untreated hypospadias have adverse outcomes? A pilot study using a social media advertised survey. J Pediatr Urol. 2014 Aug;10(4):672-679.

    Schneuer FJ, Holland AJ, et al. Prevalence, repairs, and complications of hypospadias: an Austrailian population-based study. Arch Dis Child. 2015 Nov;100(11):1038-1043.

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