What is hypospadias repair?

Hypospadias is a problem with the opening of the urethra. The urethra is the tube that carries urine from the bladder to outside the body.

In boys, the opening of the urethra is usually at the end of the penis. But sometimes the urethra does not reach the end of the penis. In this case, the opening is on the underside of the penis.

Surgery can make a new opening at the end of the penis. The way the doctor does this depends on how serious the problem is. In some cases, the doctor can take tissue from inside the mouth to make the urethra longer. In other cases, the doctor needs to do more than one surgery to fix the problem. Your doctor will talk to you more about this.

After surgery, your child may have a short, plastic tube in his urethra. The tube is called a stent. It keeps the urethra open. Or your child may have another kind of tube called a catheter. It drains urine from the bladder. These will be removed in about 10 to 14 days.

Your child may be able to go home the same day. Or he may need to stay in the hospital for 1 to 2 days.

Activity

• Let your baby rest as much as possible. Sleeping will help him recover.
• You can give your baby a sponge bath the day after surgery. Do not give him a bath for 5 to 7 days.

Medicines

• Your doctor will tell you if and when your child can restart his or her medicines. The doctor will also give you instructions about your child taking any new medicines.
• Your doctor may recommend giving your baby acetaminophen (Tylenol) to help with pain after the procedure. Be safe with medicines. Read and follow all instructions on the label. Do not give aspirin to anyone younger than 20. It has been linked to Reye syndrome, a serious illness.
• Do not give your child two or more pain medicines at the same time unless the doctor told you to. Many pain medicines have acetaminophen, which is Tylenol. Too much acetaminophen (Tylenol) can be harmful.
• If the doctor prescribed antibiotics for your child, give them as directed. Do not stop using them just because your child feels better. Your child needs to take the full course of antibiotics.

Incision and catheter or stent care

• Your child will probably have a dressing over the cut (incision). A dressing helps the incision heal and protects it. Your doctor will tell you how to take care of this.
• Your child may have a stent or catheter for about 2 weeks. Your doctor will tell you how to take care of this.
  • The catheter or stent will empty urine into your baby's diaper. Change the diaper as your doctor suggests.

Surgery can be stressful for both your child and you. This information will help you understand what you can expect. And it will help you safely prepare for your child's surgery.

Preparing for surgery

• Talk to your child about the surgery. Tell your child that the surgery will fix a problem with the penis. Hospitals know how to take care of children. The staff will do all they can to make it easier for your child.
• Ask if a special tour of the surgery area and hospital is available. This may make your child feel less nervous about what happens.
• Plan for your child's recovery time. Your child may need more of your time right after the surgery, both for care and for comfort.
• Understand exactly what surgery is planned, along with the risks, benefits, and other options.
• Tell the doctor ALL the medicines, vitamins, supplements, and herbal remedies your child takes. Some may increase the risk of problems during the surgery. Your doctor will tell you if your child should stop taking any of them before the surgery and how soon to do it.

The day before surgery

• A nurse may call you (or you may need to call the hospital). This is to confirm the time and date of your child's surgery and answer any questions.
• Remember to follow your doctor's instructions about your child taking or stopping medicines before surgery. This includes over-the-counter medicines.

Hypospadias means that the opening of the tube (urethra) leading from the bladder does not extend to the tip of the penis. Instead, the opening is on the underside of the penis.

To repair this, the doctor created a new opening that allows urine to drain as it should through the penis.

After the procedure, your baby's penis may look red and swollen. Your baby may also have pain. Medicines can help with pain. Swelling or bruising should start to go away 2 to 3 weeks after surgery.

Your baby may have a short, plastic tube (a stent) or a catheter to keep the urethra open. If this is the case, it will need to stay in place for about 10 to 14 days.

Your baby may seem fussy while the penis heals. Your baby may have some pain if the bladder tightens suddenly (spasm) or when your baby urinates after the stent or catheter is removed. This pain usually gets better within 3 or 4 days. But it may last for up to 2 weeks.

• Follow the instructions exactly about when your child should stop eating and drinking. If you don't, the procedure may be canceled. If your doctor told you to have your child take any medicines on the day of the procedure, have your child take them with only a sip of water.
• Follow the doctor's instructions about when your child should bathe or shower before the surgery. Do not apply lotion or deodorant.
• Be sure your child has something that's a reminder of home. A special stuffed animal, toy, or blanket may be comforting. For an older child, it might be a book or music.

At the hospital or surgery center

• A parent or legal guardian must accompany your child.
• Your child will be kept comfortable and safe by the anesthesia provider. Your child will be asleep during the surgery.
• The surgery will take 1 to 3 hours.
• After surgery, your child will be taken to the recovery room. As your child wakes up, the recovery staff will monitor your child's condition. The doctor will talk to you about the surgery.
• Your child may be able to go home the same day. Or your child may need to stay in the hospital for 1 to 2 days.