This surgery is used to treat 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.
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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.
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
- 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. After the procedure, the doctor will give your child pain medication.
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
Encourage light, gentle play while the penis is healing. Follow any instructions on wound care to prevent infection.
Call Your Child’s Doctor
Contact your child's doctor if their recovery is not progressing as expected or they develop complications such as:
- 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
If you think you have an emergency, call for emergency medical services right away.
American Urological Association
Healthy Children—American Academy of Pediatrics
Canadian Urological Association
Canning DA. Can we correct hypospadias with a staged operation? If not, are we bold enough to report it? J Urol. 2015;194(2):284-285.
Hypospadias. EBSCO DynaMed Plus website. Available at:http://www.dynamed.com/topics/dmp~AN~T113719/Hypospadias. Updated June 28, 2016. Accessed December 18, 2017.
Hypospadias/chordee. Cincinnati Children’s website. Available at: https://www.cincinnatichildrens.org/health/h/hypospadias. Updated April 2016. Accessed December 18, 2017.
Schlomer B, Breyer B, Copp H, Baskin L, DiSandro M. Do adult men with untreated hypospadias have adverse outcomes? A pilot study using a social media advertised survey. J Pediatr Urol. 2014;10(4):672-679.
Schneuer FJ, Holland AJ, Pereira G, Bower C, Nassar N. Prevalence, repairs, and complications of hypospadias: an Austrailian population-based study. Arch Dis Child. 2015;100(11):1038-1043.
Last reviewed November 2018 by EBSCO Medical Review Board Adrienne Carmack, MD Last Updated: 12/20/2014