Hypospadias is a birth defect found in boys. The urethra, the tube that urine comes out of the body through, does not come out at the tip of the penis. The urethra can be seen on the shaft of the penis or below the scrotum. Hypospadias can also occur with a defect called chordee. Chordee is a downward curve of the penis. Chordee is not always noticeable and may only be seen when the penis is erect.
Hypospadias is common and occurs in 1 out of 300 live male births. Sometimes this runs in families. The exact cause for this is not fully known. Hypospadias is normally found during an exam after birth. Circumcision is not done until an exam is done by the urologist because the foreskin can be used to rebuild the urethra during surgery.
Hypospadias is treated with surgery. It is usually not done until your child is 6-12 months old. The exact age of repair depends on the size of the penis and how severe the defect is. If your child has chordee, this is repaired at the same time as the hypospadias. Your surgeon will talk with you about surgery at the time of your clinic visit.
The goals of surgery are to straighten the bend of the penis and bring the urethra to the tip of the penis where it should be. Treatment is important because a straight penis is needed for normal reproductive health and sexual function. If not treated, it can be harmful to a boy’s normal social growth and development.
Care After Surgery
After surgery, your child will go to the recovery room. Most children go home the same day or the next day.
Most boys have a small tube coming out of the opening of their penis. This tube is called a stent. The stent protects the new urethra and allows for proper healing. It is sewn into the penis and is gently removed by your surgeon at the follow-up visit. If the stent comes out at home, do not try to push the tube back in. If it comes out, cut it free. There is no need to go to the emergency room.
Once the stent is removed, your child will begin sitz baths 3 times per day at home. This is reviewed with you before he goes home from the hospital. He is not able to take tub baths until the stent is removed.
Your child’s penis will have a clear sticky dressing wrapped around it. Put bacitracin ointment on the tip of the penis until the clear dressing comes off. Once the dressing falls off, stop the bacitracin. Do not put on a new dressing. You will notice a lot of redness, swelling and bruising of the penis and some spotty bleeding along the wounds.
No strenuous activity or straddling toys for 2 weeks after surgery. It is best to try and keep your child flat as much as possible for 24 hours. Walking, lying or crawling are the other best positions. Try not to have him sit all day.
When to Call the Doctor
• Bleeding (spotting is OK).
• Pus or foul smelling drainage from wound or penis.
• Fever over 101.5°F under the arm.
• Pain not relieved by the pain medicine.
• Signs of dehydration.
o Less than 3 wet diapers/voids in 24 hours.
o Dark yellow urine.
• No bowel movement for 3 days.
Pediatric Urology Clinic: Monday to Friday 8:00am-4:30pm
Toll free: 800-323-8942
After hours and weekends, the clinic number is answered by the paging operator. Ask for the Urology Resident on call. Leave your name and phone number with the area code. The doctor will call you back.
The information provided should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Any duplication or distribution of the information contained herein is strictly prohibited.
Last Updated: 11/13/2013
Copyright © 11/07/2013 University of Wisconsin Hospitals and Clinics Authority. All rights reserved. Produced by the Department of Nursing. HF#6319
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