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Hypospadias: Discharge instructions

Article Translations: (Spanish)

What is hypospadias?

Hypospadias occurs when the urethra (the opening where the urine comes out) is on the underside of the penis instead of the tip. Hypospadias may be mild, moderate, or severe, depending on how far back the opening is and how much chordee (downward curve), if any, is present. The cause is not known, but it can occur in other family members.

Why is surgery needed?

Boys with hypospadias urinate in a downward stream rather than out and away from the body. This causes wet clothes and shoes. If not repaired, hypospadias may make future sexual intercourse difficult, and could affect fertility.

The operation involves making a new opening on the tip of the penis. If a chordee is present, it will be corrected at the same time. After healing most boys have normal function and appearance of the penis.

What can I expect after surgery?

Most boys go home the day of surgery. There may be some soreness or pain in the penis and abdomen (belly). Medicine will be prescribed for pain. Medicine may also be given to prevent bladder spasms. Your son may be fussy and need to be held more.

There may be a catheter or stent (small plastic tube) in the penis to drain the urine for several days after surgery. It is usually stitched in place. Your surgeon will let you know how long the tube needs to remain in place. Typically this is one to two weeks. Call your physician's office to coordinate removal. Special care of this tube is not needed. It is usually taken out 1 or 2 weeks after surgery. Once the tube is removed, your child will likely have burning with urination the first few times. If this becomes intolerable for your child, or they are unable to urinate at all, call your surgeon.

There should be a constant dribbling of urine from the tube unless your doctor tells you otherwise. Urine may be pink to red-tinged.

There will be an incision on the penis. The stitches will dissolve within a few weeks. A plastic dressing may cover the incision. It usually comes off on its own after 4 to 7 days. It is important that the dressing not retract towards the base of the penis. If so, it can cause significant problems. Contact your surgeon's office immediately if the plastic dressing retracts towards the base of the penis.

Once the dressing has fallen off or is removed, expect significant swelling over the next 24-48 hours. It should then begin to gradually improve.

How should I care for my son?

If bleeding occurs, apply gentle pressure to the incision for 5 minutes. If bleeding does not stop or starts again, call the surgeon.

We recommend that you bathe your child once a day and as needed (after bowel movements) in plain water for 5-10 minutes. Your child may be given a bath on the day of surgery if necessary. However, you should discuss this with your surgeon. Some parents have found a bath ring is more comfortable for their baby. Never leave your child alone in the bath.

Once the plastic dressing is off, apply an antibiotic ointment to the incision at each diaper change, or 4 times a day for boys not in diapers, for 1 week. Let it melt around the area; do not try to spread it. The ointment helps prevent infection around the stitches.

A larger diaper over the regular size diaper can provide extra padding.

Loose fitting, comfortable clothes (such as sleepers, sweat pants, or gym shorts) will be best after surgery. It helps to use clothes that are a size larger than normal.

For older boys, you may use a lap tray to "tent" the blankets. This avoids any rubbing or pressure on the penis. A cardboard box can be made into a lap tray.

What can my child eat?

Starting with a bland meal, your child may go back to his or her regular diet.

How active can my child be?

Healing can take several days. Encourage quiet play or non-strenuous activity initially. Your child should be able to return to normal activity within a week.

What else do I need to know?

See your Patient Discharge Summary sheet for specific instructions about pain medicines and when to see the surgeon again.

When should I call the surgeon?

  • plastic dressing slides down toward the base of the penis
  • plastic dressing seems too tight
  • child pulls the plastic dressing off
  • bleeding from the incision that does not stop after 5 minutes of gentle pressure
  • problems with the catheter or stent:
    - no urine coming out
    - leaking around tube
    - tube seems to have moved in or out
    - tube falls out
  • pain that is not relieved with the prescribed medicine
  • vomiting the day after surgery
  • temperature higher than 102° F
  • increasing swelling, redness, or pain in the penis
  • cloudy drainage coming from the incision

Questions?

This sheet is not specific to your child, but provides general information. If you have any questions, please call the clinic.

Children's Hospitals and Clinics of Minnesota
Patient/Family Education
2525 Chicago Avenue South
Minneapolis, MN 55404
Last reviewed 8/2015 ©Copyright

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This page is not specific to your child, but provides general information on the topic above. If you have any questions, please call your clinic. For more reading material about this and other health topics, please call or visit Children's Family Resource Center library, or visit www.childrensmn.org/educationmaterials.

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