Hypospadias repair

Definition

Hypospadias repair is surgery to correct a birth defect in boys called hypospadias. This is a condition in which the urethra does not properly exit the penis at the tip.

Hypospadias can be a mild defect—with the urethral opening slightly out of place, near the tip of the penis—or a severe one—with the urethral opening closer to the scrotum. Hypospadias is also frequently associated with a shortening or downward bending of the penis and malformation of the foreskin.

Description

Surgical repair of hypospadias is done while the child is unconscious and pain-free under general anesthesia. The type of repair depends on the severity of the defect. Mild defects may be repaired in a single procedure, while severe defects may require 2 or more procedures.

A small piece of foreskin or tissue from another site can be used to create a tube to extend the urethral length to allow placement of the urethral opening at the tip of the penis.

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

Indications

Hypospadias is one of the most common birth defects seen in infant boys. Surgery is usually necessary to allow normal urination, to correct the penis deformity, and to ensure normal sexual functioning. The repair is usually performed before the child reaches school age.

If the deformity will not impede normal standing urination, normal sexual function, or deposition of semen, surgical repair is not required.

RISKS
Risks for any anesthesia include the following:

• Reactions to medications
  
• Problems breathing

• Bleeding
  
• Infection

Expectations after surgery
Outcome is usually good following surgical repair. Multiple operations may be planned or required in the future.

Convalescence

Immediately after surgery, the penis is securely taped to the abdomen to for stability. Medications may be given to relieve pain. The child is encouraged to take fluids to maintain urine output, to avoid pressure on the urethra. In general, surgery is performed on an outpatient basis. A urinary catheter may be required for a period after the operation.

Lots of fluids and frequent urination should continue after release from the hospital. Strenuous activity should be avoided until the surgical repair is fully healed.

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