Successful treatment of hypospadias

Frequently Asked Questions

Is hypospadias passed through genes?

In about 7 out of 100 children with hypospadias, the father also had it. The chance that a second son will be born with hypospadias is about 12 out of 100. If both father and brother have hypospadias, the risk in a second boy increases to 21 out of 100.

Is it necessary to fix distal hypospadias?

Many parents ask if surgery is needed for mild forms of hypospadias. It’s hard to predict problems a baby will have later in life. But there are many reasons for recommending correction, no matter how severe the condition.

• As many as 15 out of 100 boys with hypospadias will have a penis that curves downward. When the curve is severe, when the boy is an adult it can interfere with getting an effective erection.
• While the meatus may be in a nearly normal place, it’s often deformed. Some holes are larger while others are too small. Many have a web of skin just beyond the opening. These abnormalities can affect the urine stream. Some boys will notice urine spraying to the sides or downward. Many find they need to sit to void. Voiding can cause discomfort and irritate nearby tissues. The penis works, but these problems can be embarrassing.
• A partly formed foreskin that isn’t fixed will always appear abnormal. This can call attention to the problem. Studies of boys with uncorrected hypospadias suggest lower self-esteem.

Most pediatric urologists today suggest fixing all but the most minor forms of hypospadias. In most cases, the benefits of correction far outweigh its risks.

What kind of anesthesia is used? Is it safe to put infants to sleep?

Hypospadias repair is done while the patient is asleep, under general anesthesia. Many anesthesiologists or surgeons also use nerve blocks near the penis or in the back to reduce discomfort when the child wakes up after surgery. These forms of anesthesia are very safe, especially when given by anesthesiologists who specialize in the care of children. Today, it’s thought safe to do surgeries such as hypospadias repair in otherwise healthy infants.

Which repair is best for my son?

The method your son’s urologist chooses will depend on a number of factors. These include the degree of hypospadias and how much the penis curves. The surgeon won’t know the complete situation until the operation is under way. Surgeons who do hypospadias repair must be familiar with many techniques. Sometimes even a mild distal hypospadias may turn out to need a more complex repair. Most hypospadias repairs are done by pediatric urologists with special training and skill.

How do I care for my son’s wound after surgery?

Hypospadias repair wounds don’t call for special care to heal the right way. The surgeon may choose from many band age types or not use any at all. The surgeon will instruct you on care of the wound and bathing. If your son has a catheter, it may be left to drain into diapers. Diapers can be changed as usual. If your son is older, the catheter may be connected to a bag. Your health care provider will teach you how to empty the bag. Catheters are often kept in place for 5 days to 2 weeks.

How long will the healing take?

Wound healing from hypospadias repair starts at once. But it may take many months for it to heal fully. There may be swelling and bruising early on. This gets better over a few weeks. Sometimes the skin of the penis heals with what seems like an unsightly ruffle. There may also be more obvious complications. Any recommendations for more surgery won’t be made for at least 6 months, to let the tissues heal. Many slight imperfections will also resolve during this time.

If my child still has problems after many operations, can his hypospadias still be repaired?

Yes. Luckily, most operations are a success the first time. Yet, a few children need more surgery because of complications. Most of them will have good results the second time. Still, a few may have problems that lead to even more surgery. But these problems can be fixed.