Hypospadias Surgery in Infants

Hypospadias surgery is a procedure to correct a congenital abnormality in which the urethra does not grow correctly in the penis of an infant. In this blog, we will explore why hypospadias surgery is performed, what happens during the surgery, and what to expect afterward.

Why is hypospadias surgery performed?

Hypospadias surgery is performed to correct a birth defect where the urethra opening is not at the tip of the penis. The objective of hypospadias repair is to achieve a straight penis with the urethra in the correct location. Hypospadias infants should not be circumcised. However, the surgeon may use additional skin from the uncircumcised foreskin for the repair.

During the surgical procedure, the urologist:

  • Aligns the penis shaft.
  • Constructs a new urethra.
  • Place the entrance of the urethra at the apex of the penis.
  • Reconstructs the foreskin.

What to expect during the surgery on your child?

  • General anesthesia will be administered to keep your child unconscious and pain-free.
  • Sometimes, two operations may be necessary to straighten the penis and repair the urethra, but usually, both procedures are performed simultaneously.
  • Your child can typically go home on the same day of surgery.

What occurs following hypospadias surgery?

  • The infant may need a catheter to urinate, which can stay in place for a few days to two weeks.
  • Antibiotics may be prescribed to reduce the risk of infection.
  • Pain medication can be given to alleviate discomfort.

Risks associated with hypospadias surgery:

  • Fistula (an abnormal connection between the penile skin and the urinary tract) can occur.
  • Scarring can impede urine flow in some infants.
  • Consult a doctor or nurse if your child is leaking urine or has a weak, slow urine stream after surgery.

How should I care for my infant following surgery?

You will receive instructions on how to care for your baby during their recovery, including how to:

  • Bathe your child.
  • Take care of the dressing.
  • Acknowledge infection symptoms and their consequences.

Follow the instructions accurately and closely monitor your child’s recovery and the surgical site. The complete healing process takes several months. You may see bruising and swelling in the first few weeks, but these symptoms soon subside.

Can adult children get surgery for hypospadias?

Yes, children and adults of any age can have hypospadias corrected surgically.

Is hypospadias synonymous with a crooked penis?

They are distinct conditions. However, babies with hypospadias may have a curved penis. This is called “chordee” or “congenital penile curvature” and can happen at birth.

Can a child avoid developing hypospadias?

There is no guaranteed way to prevent hypospadias from occurring, but some factors may decrease the risk. A healthy lifestyle while the mother is pregnant, such as not smoking or drinking alcohol, maintaining a healthy body mass index, and taking 400 to 800 mcg of folic acid daily, can help reduce the likelihood of hypospadias.

What is the prognosis for children affected by hypospadias?

The effectiveness of hypospadias (and chordee) repair techniques is exceptional. Most fixes are permanent, and the penis functions normally and healthily. Your child’s healthcare professional will explain any necessary follow-up appointments.

How can I best care for my infant?

If your child has undergone surgery for hypospadias, do not allow them to play with toys that require straddling, such as riding toys or walkers, until your doctor gives the all-clear. You may also wish to use two diapers for added padding.

When should I consult a doctor?

Your infant will most likely recover without any difficulties. However, there are certain situations in which you should consult a doctor, including:

  • A blue or grey discoloration near the tip of the penis
  • A fever of 102 degrees Fahrenheit or higher that has persisted for more than 24 hours
  • Hemorrhage at the surgical site
  • Pain despite the use of analgesics
  • Urinary difficulty or inability

If your child is experiencing severe pain or any of the above symptoms, you should contact your doctor immediately.

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