ABOUT TREATMENT
Hypospadias Repair
Hypospadias is a congenital condition in which the opening of the urethra is located on the underside of the penis rather than at its usual position at the tip. It may also be associated with a downward curvature of the penis (chordee) and an incomplete or hooded foreskin.
SYMPTOMS
Common Symptoms
Hypospadias is usually treated surgically to:
* Bring the urinary opening to a more normal position
* Correct any curvature of the penis
* Allow the child to pass urine in a normal direction
* Achieve a functional and satisfactory appearance of the penis
CAUSES
Causes of Hypospadias Repair
Genetic factors — having a family member with hypospadias can increase risk.
Hormonal factors — problems with androgen production or the body's response to androgens during fetal development may play a role.
Fetal development — the urethra and penis develop during pregnancy, and disruption of this process can result in hypospadias.
Maternal/fetal factors during pregnancy — some pregnancy-related factors have been associated with increased risk, although they do not necessarily cause the condition.
Prematurity or low birth weight — these have been associated with a higher incidence.
Assisted reproductive technology — some studies have reported an association, although the relationship is not completely understood.
RISK FACTORS
Risk Factors
Family history: A child is more likely to have hypospadias if a close family member has had the condition.
Genetic factors: Certain genetic changes may affect normal development of the urethra and penis.
Premature birth: Babies born prematurely have a higher reported incidence.
Low birth weight: Lower birth weight has been associated with increased risk.
Maternal age: Some studies have found an association with higher maternal age.
Assisted reproductive technology: Some studies report a higher incidence following treatments such as IVF, although the exact relationship remains uncertain.
Hormonal factors: Altered androgen activity during fetal development may contribute.
Certain pregnancy factors: Some maternal or placental factors may influence fetal genital development.
DIAGNOSIS
Diagnosis
A pediatrician or pediatric urologist examines:
The location of the urethral opening
The shape and development of the penis
Penile curvature (chordee)
The foreskin, which may appear incomplete or hooded
The position and size of the testicles
The doctor identifies the type and severity based mainly on where the urethral opening is located:
Distal/anterior hypospadias
Midshaft hypospadias
Proximal/posterior hypospadias
TREATMENT OPTIONS
Treatment Options
Treatment depends on the location of the urethral opening, degree of penile curvature, severity of hypospadias, and the child's overall health.
Single-Stage Repair : For many distal and some midshaft cases, the repair can be completed in one operation. Techniques are selected according to the individual anatomy.
Staged Repair : More severe or proximal hypospadias, particularly when significant curvature or insufficient tissue is present, may require two or more surgical stages.
Treatment of Penile Curvature : If significant curvature (chordee) is present, it may be corrected during the repair. The exact technique depends on the severity and anatomy.
BENEFITS
Benefits of Treatment
Improved urine flow and direction by repositioning the urethral opening.
Correction of penile curvature (chordee) when significant curvature is present.
Improved penile appearance by creating a more typical position of the urethral opening.
Better urinary control and hygiene in appropriate cases.
Support for normal sexual function in adulthood, depending on the severity and surgical outcome.
Improved confidence and psychological well-being related to genital appearance and function.
Early correction can address functional concerns before the child reaches later childhood or adolescence.
RECOVERY
Recovery & Aftercare
After Surgery
A urinary catheter or stent may be kept temporarily to allow the repaired urethra to heal.
Mild swelling, bruising, or discomfort can occur during the early recovery period.
Pain medicines prescribed by the doctor can help keep the child comfortable.
Parents should follow the surgeon's instructions for wound care, bathing, medicines, and activity.
Recovery Timeline
First few days: Swelling and discomfort are generally most noticeable.
1–2 weeks: The surgical area gradually heals; activity may still need to be restricted.
Several weeks: Most children gradually return to their normal activities as advised by their surgeon.
Follow-up: The surgeon checks healing and urinary function and monitors for complications.
PREVENTION
Prevention
Keep the surgical area clean and dry as instructed.
Prevent pressure or injury to the surgical site.
Give prescribed medicines as directed.
Avoid activities such as cycling, straddling toys, or vigorous play until the surgeon gives clearance.
Attend all scheduled follow-up appointments.
COMPLICATIONS
Possible Complications
Urethral fistula: A small abnormal opening may develop between the urethra and skin, causing urine to leak through it.
Meatal stenosis: Narrowing of the new urethral opening may affect urine flow.
Urethral stricture: Narrowing of part of the reconstructed urethra can cause difficulty passing urine.
Wound infection: Infection can occur at the surgical site.
Bleeding or hematoma: Blood collection or bleeding may occur after surgery.
Wound breakdown: Part of the repaired area may separate during healing.
Recurrent penile curvature: Curvature can occasionally persist or return, particularly in more severe cases.
Cosmetic concerns: The appearance may not be exactly as expected after healing.
Need for additional surgery: Some complications may require another procedure to achieve the desired functional result.
WHEN TO CONSULT A DOCTOR
When Should You Consult a Doctor?
The urine opening is not located at the tip of the penis.
The penis appears curved downward, especially during erection.
The foreskin appears hooded or incomplete around the tip.
The child has difficulty urinating or directing the urine stream.
There is significant spraying or an unusually weak urine stream.
The penis appears significantly different from expected genital development.
The child has already undergone hypospadias repair and develops urine leakage from another opening, difficulty passing urine, bleeding, infection, or recurrent curvature.
RELATED TREATMENTS
You May Also Be Interested In
Explore other advanced urology treatments offered by our clinic.
Female Urology
Comprehensive diagnosis and advanced treatment for female urinary disorders including urinary incontinence, recurrent urinary tract infections, overactive bladder, pelvic floor disorders and bladder dysfunction.
Read More
Vesicovaginal Fistula (VVF) Repair
Vesicovaginal Fistula (VVF) is an abnormal connection between the bladder and vagina that can cause continuous urine leakage. VVF repair aims to close the fistula, restore normal bladder function, and improve quality of life through appropriate surgical treatment.
Read More
Kidney Stone Treatment
Advanced diagnosis and minimally invasive treatment for kidney stones using Laser Lithotripsy, RIRS, PCNL and other modern techniques with faster recovery.
Read More
YOUR HEALTH MATTERS
Need Expert Urological Care?
Get compassionate, advanced and personalized urology care from Dr. Anjali Choudhary. Book your consultation today and take the first step towards better health.