The surgery is done while the child is under general anesthesia (asleep and pain-free). The type of repair depends on the severity of the defect. Mild defects may be repaired in one procedure. Severe defects may need two or more procedures.

A small piece of foreskin or tissue from another site can be used to create a tube that reaches the length of the urethra. The urethra is the tube that releases urine from the body. Extending the length allows an opening to be placed at the tip of the penis.

Circumcision should not be performed at birth in boys with hypospadias. This is so that the foreskin can later be used for the repair.

This surgery is performed on boys who are born with hypospadias. Hypospadias is one of the most common birth defects seen in infant boys. Surgery is usually necessary to:

• Allow normal urination
• Correct the penis deformity
• Ensure normal sexual functioning

The repair is usually performed before the child reaches school age.

Surgical repair is not needed if the condition does not affect normal standing urination, sexual function, or the deposit of semen.

The most common complication is swelling of the penis. This swelling usually goes away within a few days.

Risks for any anesthesia include the following:

• Breathing problems
• Reactions to medications

Risks for any surgery include the following:

• Bleeding
• Infection

The patient usually does well after surgery. Several operations may be needed.

Immediately after surgery, the penis is securely taped to the abdomen so that it does not move. Medications may be given to relieve pain. The child is encouraged to drink fluids to maintain urine output. This avoids pressure on the urethra.

Surgery is usually performed on an outpatient basis. The child may need a urinary catheter for a while after the operation.

After leaving the hospital, the child should continue to drink plenty of fluids to urinate often. The child should avoid strenuous activity until fully healed.

Borer JG, Retik AB. Hypospadias. In: Wein AJ. Wein: Campbell-Walsh Urology. 9th ed. Philadelphia, Pa: Saunders Elsevier; 2007: chap 125.