Hypospadias

Hypospadias is a name given to a group of conditions in which the urethral opening is located on the bottom of the penis. It is one of the most common congenital abnormalities of the male genitalia. It may or may not be associated with a chordee, a condition where the penis is abnormally bent.

What Can I Expect from Surgery?

Depending on the place of the urethral opening and the presence of a chordee, the repair may be done in one or several stages. The surgeon will explain this to you.

The goals of the repair are to provide an adequate urethra and to place the urethral opening at the tip of the glans. If a chordee is present, the penis is straightened to permit future functioning for sexual intercourse. Your son may or may not have a catheter or stent after the operation.

The operation is done on an outpatient basis. Your child goes to the hospital on the day of surgery and then goes home a few hours after he recovers. Lab work is not necessary unless your son has other medical problems.

Time off Work

A consistent, reliable, caregiver is essential for 7-10 days after surgery to protect the sutureline and to care for the catheter. Plan on a total of 10 days off work including the surgical day. Your son will need to be closely supervised,to protect the surgical site, prevent injury and allow for better healing.

Important Notes:

  • Please keep the office staff up to date with a change in phone#, address or pediatrician. We may need to reach you in an emergency.
  • If your child becomes ill (fever, rash, cold) the week before surgery please contact our office immediately (410) 328-5730.

Tips for the Day of Surgery:

Bring for your son:

  • A variety of favorite toys, music tapes, or books to encourage quiet time.
  • A special toy or security blanket that may help to comfort you child.
  • Extra pacifiers or teething toys to help soothe your baby.
  • A change of clothes and loose clothes to wear home from the hospital.

Bring for Yourself:

  • Any activity you enjoy to help pass the time.
  • Snacks or money to buy yourself a meal. Please do not eat in front of your child.

It is best, when possible, to make arrangements for siblings to stay at home on the day of surgery, in order for you to participate fully in your child’s care.

Post Operative Discharge Instuctions:

Depending on the severity of the Hypospadias, a urinary catheter or urethral stent may be placed during the operation to facilitate urethral healing. If so, your son will be sent home with a prescription for antibiotics to be taken orally until the catheter or stent is removed.

Care of the Catheter or Stent:

Care of a Catheter: Secure drainage bag to the leg. DO NOT allow tension on the catheter. Check sutures once a day to make sure they are secure. Do not clamp off the catheter.

Care of a Stent: A urethral stent is a clear “strawlike” tube that protrudes from the penis about one inch. It is sutured in place at the tip. Check sutures daily to make sure they are secure. Change diaper frequently. Apply Triple Antibiotic Ointment to the tip of the penis every diaper change. The stent will be removed in the office 5-10 days after surgery.

Care of the Incision:

Tegaderm: A clear plastic dressing will be around the entire penis. If it has not fallen off after 5 days, gently remove it. Apply Neosporin ointment over the entire suture line with every diaper change for 10 days after surgery.

Feeding Your Child After Surgery:

Your child may have a regular diet for age, however his/her appetite may not be normal for 24-36 hours. This is normal. If so, give frequent small amounts of clear liquids (juice, soda, sugar water).

Constipation is common after surgery. Anesthesia and pain medicine (Roxicet) can contribute to constipation. Give your child plenty of clear liquids after surgery. Call the office if you child goes longer than 48 hours without a bowel movement.

Bathing Instructions:

Keep the diaper area clean and dry. DO NOT rub or pull. Gently wash and pat dry twice daily. There will be some swelling and bruising around the penis for 3-5 days. If there is a stent or catheter, DO NOT TUB BATHE UNTIL IT IS REMOVED.

Activity:

  • 0-8 months: Normal activity for age. 
  • 8 months - 2-1/2 years:  STRONGLY SUGGEST PLAYPEN OR ADULT SURPERVISION.
  • Be careful of toddler accidents for 2 weeks.
  • No straddle toys (rocking horse, bikes or trikes.) No sandbox No swimming. 2-1/2 years - 12 years: Quiet supervised play for 24-48 hours. No running, contact sports, or vigorous activity for 4 weeks.

Daycare/School:

Your child must be closely supervised to avoid accidents for 14 days. He may return to school 48-72 hours after surgery. No physical education classes for 4 weeks.

Call 410-328-5730 for any questions or if there is:

  • Bleeding or excessive drainage
  • Fever above 101 F
  • Vomiting
  • Not making urine (or decrease in wet diapers)

*If you have any questions about the surgery, please call: the nurse practitioner or surgeon caring for your child: 410-328-5730.

This page was last updated: March 7, 2013

         
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