No medicine will correct a chordee or hypospadias, and the child will not outgrow these conditions. Surgery is recommended and is almost always successful when performed by an experienced pediatric urologist.
The goals of surgery are:
- To bring the urethral opening to the tip of the penis to allow a controlled stream of urine while standing
- To straighten the penis, if a chordee is present, therefore allowing an unrestricted erection
- To improve the appearance of the penis
- To deter fertility issues later in life
At birth, your child will not be able to undergo a circumcision because the foreskin may need to be used for the surgical repair. Doctors prefer to perform the hypospadias surgery between 6 -24 months of age. However, the surgery can be done at a later age.
The surgery is usually done on an outpatient basis. This repair may need to be done in multiple stages. Most hypospadias surgeries create a penis that functions well and looks very near normal.
Surgery for Hypospadias
The surgery is done while the patient is asleep, under general anesthesia. Sometimes, the surgeon may prefer that the child not urinate through the repaired urethra during the first few days. A small plastic tube, called a catheter, is anchored to the head of the penis with stitches. This allows the urine to flow out without coming into contact with the repair. This tube is removed in seven to 14 days in the office without causing the patient much discomfort.
A dressing is wrapped around the shaft of the penis at the end of the surgery. This will help hold down the swelling and make your child more comfortable. Remove this dressing if your child doesn't urinate within eight hours or if it rolls down and starts to tighten around the penis.
Your child will get antibiotics (medicine that will kill bacteria) and may get a medicine to stop bladder spasms.
Hypospadias surgery is very successful, but there are some potential complications. In some instances, a hole or a fistula may occur and urine may leak through the hole. The urethra would need more surgery to repair this. Scarring within the urethra may occur and cause the urethra to narrow. This may interfere with the passage of urine and would also need to be corrected with surgery. Most complications are easy to repair with additional procedures.
Patients may need to return for checkups until after puberty.