• About
• Fact sheets
• Medicines
• Find a family doctor
• Resources
• Contact us
• Mailing list
• Contribute

Hypospadias 2 - Surgery

Hypospadias is an abnormality of the penis.  It affects about one in 150-350 boys and is usually detected at birth.  There are different types of hypospadias.  See About Hypospadias more more information.

• The best age for surgery is from 6-18 months of age, depending on a number of factors.
• It is advised that your child is not previously circumcised as the foreskin may be used for the operation. 
• Following the surgery the penis can be made to look circumcised if desired.
• It is a difficult area of surgery so should be done by a qualified paediatric urologist (a doctor that specialises in that area).

Correcting hypospadias

There are several ways to correct hypospadias. They all involve surgery (having an operation). You will need to talk to your surgeon about the particular procedure suitable for your son.

The general principles are to:

1. Move the hole (urethral opening) to the tip of the penis. 
2. Close over the hole that was previously there. 
3. Fix the bend so that the penis is straight.
4. Remove the excess foreskin so it looks like the boy has been circumcised (or reconstruct a foreskin in selected cases)                   

This may be done during several operations. This allows the first operation to heal before the next one is done.

Risks

• Most boys will need a catheter after the surgery. This is short-term. A side effect from having a catheter is bladder spasms. Your son can have medication to help stop the spasms.
• There may be some bleeding from the penis.
• The wound may not heal well. Either part, or rarely all, of the wound could breakdown. Urine may then leak out of the hole. This is called a fistula.
• Stricture: the opening may narrow, which makes it more difficult to pee (pass urine).
• There may be poor correction of the bend.

Care after surgery

• Intravenous fluids
  Your son will have clear fluids going through a drip (an IV) until he can eat and drink again.
• Pain relief
  Nurses will give your son regular pain relief.
• Dressing
  There may be a dressing around the penis. If a dressing is used your doctor will tell you when this can come off.
• Antibiotics
  If needed these will be given through the IV drip. Your son may need to keep taking antibiotics by mouth at home.
• Keeping the area dry
  Vaseline should be put in the nappy or on a pad in your sons underwear to stop his penis sticking to nappies and clothing.

A note about catheters

There are many types of catheters used after surgery for hypospadias. Please talk to your nurse and get to know about your childs catheter(s). It is important that you understand some basic principles, to ensure safe handling of your child and his catheter(s) while in hospital and after you go home.

SPC (Suprapubic catheter) goes directly into the bladder through the abdomen (tummy). It is put in under a general anaesthetic (during an operation).

IDC (Indwelling Catheter) is passed into the bladder through the urethra (the hole where the urine comes out).

Dripping Stent  this tube in the penis allows urine from the bladder to drip out either into a nappy (younger child) or into a leg bag (older child).

Going home

How long your son needs to stay in hospital will depend on:

• The type of hypospadias your son has.
• How quickly he recovers from the operation.
• How comfortable you are on taking him home with a catheter, if he has one.

Please read the next factsheet: Care at home after surgery.

More information

Please read the Kids Health Info factsheets: 

• Hypospadias 1 - About
• Hypospadias 2 - Surgery
• Hypospadias 3 - Care at home after surgery