Quick Answer: What is Hypospadias and When Should Surgery Be Done?
Hypospadias is a common birth defect where the urinary opening is not at the tip of the penis. Surgery to correct this is typically done between 6-18 months of age and has excellent success rates. If your baby boy has hypospadias, don't worry - it's correctable and your child can have completely normal urinary and sexual function after repair.
Hypospadias is more common than you might think (affects about 1 in 200-300 boys). With modern surgical techniques, outcomes are excellent!
Reassurance:
---
What is Hypospadias?
Watch: Fever in kids: every detail about fever | infant care| doctor's guidance| Babynama Childcare
In hypospadias, the opening of the urethra (where urine comes out) is located on the underside of the penis instead of at the tip. It can range from mild to severe:
Type
Location of Opening
Severity
Distal/Glanular
Near tip but not at tip
Mild
Midshaft
Middle of penis
Moderate
Proximal/Penoscrotal
Near scrotum
Severe
Associated Features
Chordee: Downward curve of penis (common with hypospadias)
Hooded foreskin: Incomplete foreskin on underside
Undescended testis: May occur together
---
Why Does Hypospadias Happen?
The exact cause is often unknown, but may include:
Hormonal factors during pregnancy
Genetic factors (can run in families)
Environmental factors
Maternal use of certain medications during pregnancy
Important: It's NOT caused by anything the mother did wrong. It happens during fetal development.
---
When Should Surgery Be Done?
Age
Recommendation
**Best time**
6-18 months
Acceptable
Up to 3 years
Still possible
Any age, but better when younger
Why This Age?
Baby has grown enough for surgery
Before toilet training
Before child is aware of the difference
Better healing in young children
Less psychological impact
---
What Happens During Surgery?
The surgery corrects:
Position of urinary opening - Moved to tip of penis
Chordee - Straightens the curved penis
Foreskin - Reconstructed or removed
Key Points
Done under general anesthesia
Usually takes 1-3 hours depending on severity
Often done as day surgery (go home same day)
Sometimes needs 2 stages for severe cases
Catheter may be placed for 1-2 weeks
---
Post-Surgery Care
First 24-48 Hours
Baby may be fussy due to discomfort
Give pain medication as prescribed
Keep diaper area dry
Double diapering for extra protection
Caring for the Surgical Site
Don't remove dressing unless instructed
Keep area clean
Apply antibiotic ointment if prescribed
No baths until surgeon allows (usually 3-5 days)
Pat dry gently
Managing Pain
Use paracetamol (Calpol) for pain and any fever:
Baby's Weight
Calpol Drops (100mg/ml)
Calpol Syrup (120mg/5ml)
5-6 kg
0.5-0.6 ml
2.5 ml
6-8 kg
0.6-0.8 ml
3-4 ml
8-10 kg
0.8-1 ml
4-5 ml
10-12 kg
-
5-6 ml
Give every 4-6 hours as needed. Max 4 doses in 24 hours.
---
When to Worry After Surgery
Call Surgeon IMMEDIATELY if:
Fever above 102°F (38.9°C) lasting more than 24 hours
Blue or grey color at tip of penis
Bleeding at surgical site
No urination for 8+ hours
Catheter falls out (if one was placed)
Extreme pain despite medication
Signs of infection (pus, increasing redness, swelling)
Normal Post-Surgery Signs
Mild swelling (1-2 weeks)
Bruising (1-2 weeks)
Some fussiness (few days)
Blood-tinged urine initially
---
Recovery Timeline
Time
What to Expect
Day 1-3
Most discomfort, fussy baby
Day 3-7
Improving, less pain medication needed
Week 1-2
Catheter removal (if placed)
Week 2-4
Swelling resolving
2-3 months
Mostly healed
6 months
Full healing complete
---
Activity Restrictions After Surgery
Activity
When to Resume
Normal diaper changes
Immediately (be gentle)
Bathing
3-5 days (surgeon's guidance)
Sitting toys (walkers, etc.)
4-6 weeks
Swimming
6-8 weeks
Normal play
2-4 weeks
---
Potential Complications
Most surgeries are successful, but possible complications include:
Complication
What It Is
Solution
Fistula
Abnormal opening develops
May need minor repair surgery
Stricture
Scar tissue narrows urethra
May need dilation or surgery
Breakdown
Part of repair fails
May need revision surgery
Infection
Surgical site infection
Antibiotics
Note: Complications are uncommon with experienced pediatric urologists.
---
Long-Term Outlook
With successful surgery:
Normal urination (standing up)
Normal sexual function in adulthood
Normal appearance
No issues with fertility
Regular follow-up with urologist is important for first few years.
---
Expert Insight: As our doctors say, 'Focus on how your child looks and acts, not just the number on the thermometer.'
FAQs
Q: My baby has mild hypospadias. Does he really need surgery?
A: Even mild hypospadias is usually repaired to ensure normal urine stream direction (important for standing urination), cosmetic appearance, and prevent potential issues with sexual function later. Discuss with a pediatric urologist.
Q: Baby has fever 101°F after hypospadias surgery. What should I do?
A: Low-grade fever (up to 101°F) in first 24-48 hours after surgery can be normal. Give Calpol for comfort (dose by weight). If fever is above 102°F, lasts more than 24 hours, or baby seems very unwell, contact your surgeon immediately.
Q: Should we get our baby circumcised if he has hypospadias?
A: NO! If hypospadias is present, circumcision should NOT be done. The foreskin tissue is often needed for surgical repair. Always inform the doctor about hypospadias before any procedure.
Q: How much does hypospadias surgery cost in India?
A: Costs vary widely based on hospital, surgeon, and severity. Generally ranges from Rs. 40,000 to Rs. 2,00,000 in private hospitals. Government hospitals offer subsidized or free treatment.
Q: Will my son remember the surgery?
A: Surgery done between 6-18 months is recommended partly because children don't form lasting memories at this age. He will have no psychological trauma from the procedure.
Q: Can hypospadias recur after surgery?
A: Once properly repaired, hypospadias doesn't recur. However, complications like fistula may need additional surgery in some cases. Regular follow-up ensures any issues are caught early.
---
This article was reviewed by a pediatrician. Last updated: January 2025
---
Need personalized guidance?Book a consultation with our pediatricians or explore our Care Plans for 24/7 expert support!
Get 24/7 Expert Pediatric Care
Access 50+ pediatricians on WhatsApp anytime. Get instant answers for all your baby health concerns.
