As a parent, discovering that your newborn son has hypospadias can bring a wave of questions and concerns. Hypospadias is one of the most common congenital conditions in boys, where the urethral opening is located on the underside of the penis rather than at the tip. The good news? Modern hypospadias repair surgery is highly successful, and most children go on to live completely normal, healthy lives.
What is Hypospadias Repair Surgery?
Hypospadias repair is a surgical procedure to correct the position of the urethral opening. The primary goals are to:
- Reposition the urethral opening to the tip of the penis.
- Straighten the penis if there is associated curvature (chordee).
- Achieve a cosmetically normal appearance.
- Ensure normal urinary and, later, sexual function.
The surgery is typically performed when a child is between 6 and 18 months old, a window chosen because anesthesia is safe, healing is rapid, and the child is unlikely to remember the procedure.
Success Rates of Hypospadias Repair
Understanding success rates can provide significant reassurance. Overall, hypospadias repair has a high success rate, generally ranging from 85% to 95% for a single procedure.
However, “success” is multi-faceted and can depend on several factors:
- Severity: Success rates are highest for distal hypospadias (mild, near the tip), often exceeding 95%. More complex proximal hypospadias (closer to the scrotum) may have slightly lower initial success rates (80-90%) and a higher chance of needing a secondary procedure.
- Surgeon’s Experience: The surgeon’s expertise is one of the most critical factors. A pediatric urologist who performs these surgeries frequently tends to have the best outcomes.
- Surgical Technique: There are numerous techniques, and an experienced surgeon will choose the best one tailored to your child’s specific anatomy.
It’s important to note that even in successful cases, some children may experience minor issues like a small fistula (an extra hole) or meatal stenosis (narrowing of the opening), which can often be corrected with a minor secondary procedure.
What Parents Should Know: A Guide to the Journey
1. Before Surgery
- Diagnosis: The pediatrician typically diagnoses it at birth during the newborn exam. You will be referred to a pediatric urologist for evaluation.
- Do NOT circumcise: The foreskin is often used as tissue for the repair, so circumcision should not be performed until after consulting with the urologist.
- Consultation: Use this appointment to ask all your questions. Discuss the surgeon’s experience, preferred technique, and specific risks.
2. The Day of Surgery & Recovery
- The operation usually takes 1-3 hours under general anesthesia.
- Most surgeries are outpatient, meaning your child goes home the same day.
- Recovery involves a healing period of 1-2 weeks. Your child will have a urinary catheter (stent) for 5-10 days to allow the new urethra to heal. There will also be a dressing on the penis.
3. Post-Surgical Care at Home
Careful home care is vital for success:
- Prevent Infection: Keep the area clean and dry as directed.
- Manage Pain: Use prescribed or recommended pain relief.
- Prevent Trauma: Avoid tight clothing and activities that could bump the surgical site. Your surgeon may recommend double diapering to protect the area.
- Catheter Care: You’ll be taught how to manage the catheter until it’s removed.
4. Long-Term Outlook
With a successful repair, long-term outcomes are excellent. Boys can expect to:
- Urinate standing up with a single, forward-directed stream.
- Have a straight erection.
- Have normal sexual function and fertility in adulthood.
- Have a penis that looks cosmetically normal.
Regular follow-ups with the urologist through childhood and adolescence are standard to ensure everything continues to develop normally.
A diagnosis of hypospadias can feel overwhelming, but it’s important to remember it is a highly correctable condition. Armed with the right information and an experienced pediatric urologist, you can feel confident in moving forward. The vast majority of children who undergo hypospadias repair have an excellent functional and cosmetic result, leading to a perfectly normal, healthy life. Your role as an informed and supportive parent is the most important part of the journey.
FAQs on Hypospadias Repair
1. What is the success rate of hypospadias surgery?
The overall success rate for hypospadias repair is high, ranging from 85% to 95% after a single surgery. Success is highest for milder forms of the condition.
2. At what age is hypospadias repair done?
The ideal timing is typically between 6 and 18 months of age. This balances safety of anesthesia, optimal healing, and psychological benefits for the child.
3. Is hypospadias surgery painful?
The surgery is performed under anesthesia, so the child feels no pain during the procedure. Post-surgery, there will be some discomfort, which is effectively managed with medication prescribed by the surgeon.
4. How long does recovery from hypospadias surgery take?
Initial healing takes about 1-2 weeks. A urinary stent is usually in place for 5-10 days. Full internal healing and final cosmetic results continue to improve over several months.
5. Can a child with hypospadias be circumcised?
Not at birth. The foreskin is often needed for the repair surgery. Circumcision, if desired, can usually be performed during the same procedure to correct the hypospadias.