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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 under general anesthesia (asleep and pain-free). 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. This allows 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.

Why the Procedure is Performed

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:

Risks for any surgery include the following:
  • Bleeding
  • Infection
The most common complication is swelling of the penis. This swelling usually goes away within a few days.

Outlook (Prognosis)

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

Recovery

Immediately after surgery, the penis is securely taped to the abdomen for stability. Medications may be given to relieve pain. The child is encouraged to drink fluids to maintain urine output, and therefore 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.

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


Review Date: 8/17/2006
Reviewed By: Neil D. Sherman, MD, Urologist, Essex County, NJ. Review provided by VeriMed Healthcare Network.
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