What is a hypospadias?
A hypospadias is an abnormality of the penis which is usually identified at birth, although it can sometimes be missed for several years. It is usually characterised by:
- the opening is not in the correct place (usually further back from the tip of the penis)
- there is often bending or curvature of the penis chordee which becomes more pronounced during erection
- the foreskin is all on the topside giving a hooded appearance
- the urethral opening is often small
- one or more testes may be undescended.
If your child has a hypospadias, he will probably require an operation to repair it. A hypospadias repair may be in one or two stages, although some may be very minor. That means he may require two operations or, on some occasions, more. Stage one involves correcting the chordee and preparing for the new urethra. Stage two involves bringing the urethral opening to the tip of the penis. This is performed prior to school age. It is important if your child has a hypospadias that he not be circumcised because the foreskin will usually be used for the reconstruction.
How long will it take?
Your child will be admitted for day surgery or for an overnight stay. The operation takes about 60 to 90 inutes. This includes the anaesthetic, the operation and the time spent in the Recovery room.
When can my child eat and drink again?
If your child is awake on return to the Day Unit, he can have clear fluids immediately (babies can have a breast feed). A light diet will be offered when fully awake.
Care at home
Urine will be contained until healing occurs, either by a catheter into the penis, or a catheter which goes through the abdomen into the bladder (a suprapubic catheter/SPC). You will be required to syringe your child’s catheter if it becomes blocked, nursing staff will give you instructions and a demonstration on how to do it. Babies need to have double nappies. If the dressing is soiled by a bowel motion, clean him up as soon as possible. The inner nappy is only changed after a bowel motion.
Apply Vaseline to tip of penis to prevent it or the catheter from sticking to the nappy or underwear. Depending on the type of repair the catheter may need to remain in for four to seven days. If your child has a second stage repair, the catheter will remain in for 10 days, and the dressing will need to be changed after seven days. You will be notified about the timing suitable for your child. After the catheter is removed, it is important that you observe your child passing urine for stream deviation or fistula. The doctor will explain this to you.
Have some paracetamol or other pain relief as recommended at home because your child will need it for pain relief after the operation. Do not give aspirin.
Diet and fluids
Your child may eat and drink when feeling well.
It is not uncommon for children to vomit on the night of the operation. If he is vomiting, give sips of clear fluids, try a piece of dry toast or a cracker biscuit and increase the amounts as tolerated until the vomiting settles. If vomiting continues after 24 hours seek medical advice.
It is important to leave the dressing on. If it does come off contact the closest hospital that treats children or your doctor.
No swimming until advised by your doctor.
Points to remember
Take child to your GP or go to your closest hospital that treats children if there is excess vomiting, persistent high temperatures.
Follow up visit
If your child requires an appointment it will either be given to you before you go home or posted out to you. You will receive follow up instructions from your doctor.
To ensure your child receives the best possible care in an emergency, you should call 000 or go to your closest hospital that treats children.
If you have any concerns or questions please contact your doctor.
Contact Mater Children’s Private Brisbane
South Brisbane QLD 4101
Telephone: 07 3163 8111
Mater acknowledges consumer consultation in the development of this patient information.
Mater Doc Num: HOSP-008-06199-22
Last modified 17/11/2015.