Why is this procedure done?
Normally in boys, the urethra opens at the tip of the penis. The urethra is a tube that connects to the bladder. The urethra drains urine and takes semen out of the body. Hypospadias is a condition where the opening does not end at the tip. Instead, the urethra ends on the underside, in the middle of the penis, or near the scrotum. ‚
Doctors prefer to do hypospadias repair when your son is between 3 months and 18 months of age. The repair is done to prevent: ‚
- An abnormal curve when the penis is erect
- Problems getting a woman pregnant in the future
The surgery may be done later in childhood, or as an adult, if needed. ‚
What will the results be?
Urine and semen will be able to come out at the tip of the penis. ‚
What happens before the procedure?
Your doctor will take your childs history. Talk to the doctor about: ‚
- All the drugs your child is taking. Be sure to include all prescription and over-the-counter (OTC) drugs, and herbal supplements. Tell the doctor about any drug allergy. Bring a list of drugs your child takes with you.
- Any bleeding problems. Be sure to tell the doctor if you are giving your child any drugs that may cause bleeding. Some examples are Coumadin, ibuprofen, Aleve (naproxen), or aspirin. Certain vitamins and herbs, such as garlic and fish oil, may also add to the risk for bleeding. Your child may need to stop these drugs as well. Talk to your doctor about all of your child's drugs.
- When your child needs to stop eating or drinking before the procedure.
Your doctor will do an exam and may order: ‚
What happens during the procedure?
- Once your son is in the operating room, the staff will put an IV in his arm to give him fluids and drugs. He will also be given a drug to make him sleepy and to help him stay pain free during the surgery.
- When he is asleep, the doctors put a tube in his mouth to help him breathe. Your son will have a tube in the bladder to drain urine.
- The doctor will clean the penis with soap to kill bacteria on the skin. Then the doctor will use a drug to make the penis erect. The doctor will make a cut on the penis to see the urethra.
- Hypospadia repair involves 3 steps. The doctor may do all the steps in one surgery or in 2 to 3 separate surgeries. If done as separate surgeries, they will often be a few months apart. The steps include making the:
- Opening larger if needed
- Shaft of the penis straight
- Urethra longer so it reaches the tip of the penis. The doctor makes a new urethra by using the skin around the penis. The doctor may also use the inner arm or the lining of the mouth to make a urethra.
- The doctor will close the cut with stitches and cover the cute with a clean bandage.
What happens after the procedure?
- Your son will be taken to the Recovery Room for monitoring. The doctor will tell you if your child may go home after the procedure.
- The numbness will go away after 1 to 3 hours.
- Your son may feel some pain after the procedure. Your doctor will give him drugs for pain.
What care is needed at home?
- Ask your doctor what you need to do when you go home. Make sure you ask questions if you do not understand what you need to do to care for your child.
- There will be a tube, called a catheter, coming out of your childs penis to drain urine from the bladder. Keep the tube in place. The doctor will remove this after 5 to 15 days.
- If your child is still in diapers, let the tube drain into the diaper.
- If your child is older, there will be a bag attached to the tube.
- Drain the urine bag when it is half full. Wash your hands before and after draining. If your hands are dirty when changing the bag, it increases the chance of your son getting a bladder infection.
- The doctor will give your child drugs to prevent infection. Give the drugs as ordered by the doctor.
- Talk to your doctor about how to care for your son's cut site. Ask your doctor about:
- When you should change his bandages
- When your son may take a bath or shower
- If your son needs to be careful with lifting things over 10 pounds
- When your son may go back to his normal activities like school or daycare
- Be sure to wash your hands before touching your child's wound or dressing.
What follow-up care is needed?
- The doctor may ask you to make visits to the office to check on your childs progress. Be sure to keep your child's visits.
- If the surgery is to be done in a few steps, your doctor will tell you when the next step will take place.
- The doctor will have you make a visit to remove the tube from your son's penis.
- Your doctor may send your child to an urologist. The doctor may also suggest your child see a counselor to help him cope with the trauma after surgery.
What lifestyle changes are needed?
- Take extra care when carrying your son.
- If your child is older, he may have to limit his activity. Talk to the doctor about the right amount of activity for your child.
What problems could happen?
- Swelling
- Infection
- Bleeding
- Scarring or narrowing of the urethra
- Another opening forms
Where can I learn more?
American Urological Association Foundation ‚
http://www.urologyhealth.org/urology/index.cfm?article=130 ‚
Consumer Information Use and Disclaimer
This information is not specific medical advice and does not replace information you receive from your health care provider. This is only a brief summary of general information. It does NOT include all information about conditions, illnesses, injuries, tests, procedures, treatments, therapies, discharge instructions or life-style choices that may apply to you. You must talk with your health care provider for complete information about your health and treatment options. This information should not be used to decide whether or not to accept your health care providers advice, instructions or recommendations. Only your health care provider has the knowledge and training to provide advice that is right for you. ‚
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Copyright ‚ © 2015 Clinical Drug Information, LLC and Lexi-Comp, Inc. ‚