Your child has hypospadias. This means your child’s urethra doesn’t reach the tip of the penis. As a result, the opening of the penis (urethral meatus) is located in the wrong place. Surgery can correct this. It can also be done to correct how the penis looks. A number of methods to repair the penis can be used. Your child’s surgeon will choose the best method for treating your child. During the procedure, the surgeon will do the following:
Correct the urethra so it reaches to the tip of the penis
Move the urethral meatus to the tip of the penis
Straighten the penis, if needed
Correct how the penis looks
The surgery is usually done by a pediatric urologist. This doctor specializes in the diagnosis and treatment of urinary tract problems in children.
Surgery is typically done when the child is between 3-18 months old. More than one surgerymay be needed.
The surgery lasts about 2-4 hours. It takes place in an operating room at a surgery center or hospital. Here’s what to expect before, during, and after the surgery:
Before surgery: You will be given instructions about feeding your child before the procedure. Follow these instructions about eating and drinking carefully.
The day of surgery: You will be able to stay with your child until he is taken into the operating room. You’ll then go to a waiting room until he is out of surgery. An anesthesiologist gives your son medication so he sleeps and does not feel pain during the surgery. Special equipment monitors your child’s heart rate, blood pressure, and oxygen levels. Once your child is asleep, the surgeon will begin the procedure. The urethra is corrected so it reaches the tip of the penis. This may be done using the foreskin or a small amount of tissue from another area in the body. A tube (called a catheter) will likely be placed into the urethra at the head of the penis. This allows urine to drain freely while the penis heals. The catheter is removed when it’s no longer needed.
After surgery: Your child will be taken to a recovery room to recover from the anesthesia. Nurses monitor your child’s breathing, blood pressure, and pulse. They also give your child medication to manage his pain. Your child may be able to go home the day of the surgery. The doctor will tell you when it’s okay to take your child home.
Your child may have a stitch at the tip of his penis to hold the catheter in place. The catheter will stay in the penis until your child’s health care provider removes it. Ask your child’s health care provider how long the catheter will remain in the penis. You will also notice other stitches used to correct the hypospadias. As the penis heals, you will notice swelling, redness, scabbing, and bruising. This is normal. It takes about 3-6 months for the penis to heal completely.
To care for your child:
Care for the tube and bandage as you have been instructed. Your child’s healthcare provider will tell you whether to change the child’s bandage and how to do this. Follow all care instructions for the catheter and dressing carefully.
Manage your child’s pain by giving him prescribed medication. Follow your healthcare provider’s instructions carefully. It’s best not to wait until pain gets bad to give the medication. Your child may be in pain if he:
Cries a lot.
Refuses to eat or drink.
Grabs at the incisions.
Give prescribed medicationto your child as instructed. Some medication (antibiotics) may be given to fight infection. Other medication may help keep your child’s bladder relaxed while the catheter is in place.
Double diapering is a technique that may be used to keep the affected area dry and to keep stool off the catheter. It also helps protect your child’s penis as it heals. To double diaper:
Cut a hole in the first diaper for the tube to pass through.
Pass the tube through the hole.
Then place a second diaper on your child. This diaper will absorb urine as it drains from the tube.
In an infant under 3 months old, a rectal temperature of 100.4°F (38.0°C) or higher
In a child of any age who has a repeated temperature of 104°F (40°C) or higher
Any fever that lasts more than 24 hours in a child younger than 2 years og age, or lasts for more than 3 days in a child 2 years of age or older.
Your child has had a seizure caused by the fever
Refusal to drink
Pain not controlled with medication
Incision that bleeds and doesn’t stop
Catheter that isn’t draining urine or falls out unexpectedly
No catheter in place and isn’t urinating