Boys with hypospadias are born with the meatus (the opening where the urine comes out) on the underside of their penis instead of at the tip. Often these boys also have a downward curved shape to their penis when it is erect. This is called chordee.
A hypospadias repair is done to move the opening to the tip of the penis and to repair the curve. Hypospadias may occur in different degrees.
The morning of surgery:
Your child cannot eat or drink before surgery. Someone from the hospital will call you about this once the surgery date is set. It is important to follow these instructions. Having anesthesia is much safer when the stomach is empty.
After coming to the Day Surgery unit, your child will be given pajamas or a gown to wear. Two adults will be able to stay with your son until he goes into the operating room.
Bring your child's special bedtime toy or blanket with you to the hospital, and a few other quiet toys, such as a tape recorder with music/story tapes, family pictures, and books. Two adults may wait in the Surgical Waiting Room during surgery.
After surgery your son will go to the Post Anesthesia Care Unit (PACU). When he is awake, two adults may go into PACU and stay with him. When he is fully awake, he will go to his room.
Your child will come back from surgery with an IV. This will help to give him fluids and medicines for a day or so. He will also have a dressing around his penis. Some swelling and bruising of the penis is normal and will decrease over the next week. Your son will have to stay quiet in bed for 1-2 days.
Your child may have a small plastic tube, which is called a splint or stent, in the new opening in the end of his penis. Your child may also have a tube to drain urine from the bladder - a drippy tube or foley catheter. He will wear double diapers if he has a drippy tube to help keep him dry and reduce risk for infection.
Make sure to tell your son that his penis is not gone. Tell him that it has a bandage on it and it will feel better soon. Explain everything that happens to your son in terms he can understand.
Your child may have two types of pain: pain at the surgical site or pain caused by muscle spasm of the bladder. He will be given medicine to help relieve each type of pain.
Activity and play:
Allow your son to limit his activity himself. He should avoid climbing and playing on straddle toys for six weeks (no hobby horses, tricycles, bicycles, big wheels, or any toys he has to put his legs around). He should also avoid rough contact sports such as football, baseball, and soccer for six weeks; and avoid playing in the mud or dirt. You should continue to use your car seat even if there is a strap or section that goes between his legs.
Your child's doctor will provide you with specific guidelines. But in general, do the following:
- Wash your hands before and after giving wound care.
- Using a clean finger, gently apply fresh antibiotic ointment to the top of the penis. Do this three times a day after baths and with diaper changes.
- Your son will need to take a bath with plain warm water, one to three times a day at home for the next 7-10 days. Use plain water; do not add soaps or bubble bath. Use enough water to cover the penis when he is sitting in the tub. He should soak 15-20 minutes. The water should be a comfortable temperature.
- Your son will be taking an antibiotic at home to help prevent infection.
- Your son will be taking Ditropan if he has a "drippy tube" or a catheter. You will need to stop the Ditropan the night before you are going to see the doctor for removal of the catheter or "drippy tube."
- If your son says he is hurting, he may have a non-aspirin pain reliever. Follow the directions on the label. A prescription pain reliever may also be ordered as needed.
It is important to:
- Give your son at least 6 eight ounce glasses of liquid a day while he has a catheter or drippy tube and is taking the antibiotics. This will help prevent a urinary tract infection.
- Avoid constipation by giving your son juices, cereals, and fruits.
- Your son should wear underwear or a diaper at all times.
Signs of urinary tract infections:
- Cloudy or foul-smelling urine
- Burning when he urinates
- Passing urine often but only small amounts or not being able to go at all
- Lower abdominal pain
Signs of infection in the penis:
- Redness and more swelling
- Yellow drainage from the surgical site
- More pain when his penis is touched which gets worse each day
- Fever above 101.5º F orally or rectally
When to call your child’s doctor:
- Your son shows signs of infection.
- There is a break in the skin or the skin opens up around the stitches (The stitches will dissolve after about 7-10 days.)
- He is unable to urinate.
This handout is intended as a general guide for home care after surgery. Please follow specific instructions from your child’s doctor and call the office if you have questions.
This information is not intended to substitute or replace the professional medical advice you receive from your child's physician. The content provided on this page is for informational purposes only, and was not designed to diagnose or treat a health problem or disease. Please consult your child's physician with any questions or concerns you may have regarding a medical condition.