Hypospadias Surgery in Egypt

Expert Paediatric Urological Surgery | Professor Mohamed Elbarbary, FRCSEd

If your child has been diagnosed with hypospadias, you are not alone — and you have found the right specialist. Professor Mohamed Elbarbary is a Cairo University Professor of Paediatric Surgery with over 36 years of experience treating children with hypospadias and urological conditions. In 2026, he was awarded the Fellowship of the Royal College of Surgeons of Edinburgh (FRCSEd ad hominem) — one of the most prestigious surgical honours in the world — in recognition of his distinguished contribution to paediatric surgery.

This page answers the questions most parents ask when their son is first diagnosed: What is hypospadias? Does it always need surgery? What does the procedure involve? And what can we expect afterwards?

What Is Hypospadias?

Hypospadias is a congenital (present from birth) condition in boys in which the opening of the urethra — the tube that carries urine out of the body — is not located at the tip of the penis as normal, but somewhere along the underside of the penis, the glans, or in some cases near the scrotum or perineum.

In addition to the abnormal urethral opening (called the meatus), many boys with hypospadias also have:

• A downward curvature of the penis (chordee)

• An incomplete foreskin — often described as a "hooded" appearance

• In more severe cases, difficulties directing the urine stream while standing

Hypospadias is one of the most common urological birth defects, affecting approximately 1 in every 200 to 300 boys. In the great majority of cases, the cause is not clearly identified, though genetic and hormonal factors may play a role. It is not caused by anything you did during pregnancy.

Types of Hypospadias: From Mild to Severe

Hypospadias is classified by the position of the urethral opening:

• Glandular / Subcoronal — meatus near the glans tip (mild, most common)

• Distal penile — meatus on the shaft near the glans (mild to moderate)

• Midshaft — meatus in the middle of the penis shaft

• Proximal penile / Penoscrotal — meatus near the junction of penis and scrotum (moderate to severe)

• Scrotal / Perineal — meatus at or behind the scrotum (severe, less common)

The position of the meatus determines the complexity of the repair. Mild distal cases may require a single-stage operation; more proximal or complex cases may need a two-stage repair performed several months apart.

Does My Son Need Surgery?

For the large majority of boys with hypospadias — including almost all cases beyond the mildest glandular forms — surgical correction is recommended. Surgery is not purely cosmetic: it corrects functional problems with urination and, when curvature is present, prevents difficulties with sexual function in adulthood.

The goals of hypospadias repair are:

• To bring the urethral opening to the tip of the penis (or as close as anatomically achievable)

• To straighten any penile curvature (chordee correction)

• To create a normal-appearing penis with a complete foreskin or circumcised appearance, according to family preference

• To allow the child to stand to urinate with a normal stream

The ideal age for surgery is between 6 and 18 months. Operating at this age is recommended for several reasons: the tissues are supple and heal well; the child will not have any memory of the surgery; and the repair is complete before the child starts school and becomes conscious of his body. For boys diagnosed later, surgery can be performed at any age and outcomes are still very good.

A small number of very mild glandular cases, where the opening is just slightly displaced from the tip and there is no curvature, can sometimes be managed conservatively — but this decision is made on an individual basis after assessment by a specialist.

What the Surgery Involves

Hypospadias repair is performed under general anaesthesia. Prof. Elbarbary’s approach is guided by three decades of experience and by the individual anatomy of each child — no two cases are identical, and the technique used is chosen to give the best long-term result.

One-Stage Repair (TIP / Snodgrass)

For distal and many midshaft cases, a one-stage tubularised incised plate (TIP) repair — also known as the Snodgrass technique — is the modern gold standard. In this procedure:

• The urethral plate (a strip of tissue on the underside of the penis) is preserved and tubularised to form a new urethra

• Curvature, if present, is corrected at the same time

• The glans is shaped and a cosmetically normal appearance achieved

• A urinary catheter is left in place for 5–10 days while the new urethra heals

The operation typically takes 1.5 to 2.5 hours and the child usually goes home the same day or after one night in hospital.

Two-Stage Repair

For proximal, penoscrotal, or more complex cases — including cases where previous surgery has created scarring (re-do hypospadias) — a planned two-stage approach gives the best outcomes:

• Stage 1: The curvature is fully corrected and the penis is reconstructed using a graft (buccal mucosa from the inner cheek is often used). The child goes home and heals over 6 months.

• Stage 2: The new urethra is formed using the grafted tissue. This completes the repair.

The two-stage approach, while requiring two admissions, reliably achieves excellent results even in the most challenging cases.

Recovery: What to Expect After Hypospadias Repair

Prof. Elbarbary and his team provide written and verbal aftercare instructions before your child is discharged. Here is what most families experience:

In hospital (0–1 night)

• Your child will have a small dressing on the penis and a urinary catheter

• Pain is well controlled with simple analgesics — paediatric paracetamol or ibuprofen as directed

• Most children are comfortable within a few hours of surgery

At home — first 1–2 weeks

• The catheter remains in place and drains into a nappy or special bag — this is normal and important

• Baths are avoided; brief showers or sponge-bathing is used to keep the area clean

• Activity is restricted to calm play — no rough play, tricycles, or straddle toys

• Siblings should be careful not to bump the area

• A follow-up appointment is scheduled for catheter removal at 5–10 days post-operation

After catheter removal (weeks 2–6)

• The urine stream should gradually improve as swelling resolves

• Some temporary spraying or splitting of the stream is normal in the first few weeks

• A follow-up at 6 weeks checks the healing and assesses the cosmetic and functional result

• Full recovery, including return to all normal activities, typically takes 4–6 weeks

Warning signs to contact the clinic immediately

• Fever above 38.5°C

• Swelling or redness that appears to be worsening after the first 48 hours

• Catheter stops draining and the child appears uncomfortable

• Urine dripping from a point other than the catheter tip (fistula — uncommon)

Frequently Asked Questions

What is the success rate of hypospadias repair?

In experienced hands, distal hypospadias repair has a success rate above 90% in a single operation. Proximal or complex cases, and re-do surgery on previously repaired cases, have lower first-operation success rates — but with a two-stage approach and experienced surgical judgement, the large majority achieve excellent long-term functional and cosmetic outcomes. Complication rates (primarily fistula formation) are significantly lower when the surgery is performed by a specialist with a high volume of cases.

Can we travel from the Gulf to Egypt for this surgery?

Yes — many families travel from Saudi Arabia, the UAE, Kuwait, Qatar, Iraq, Libya, and other countries to have their child’s hypospadias repaired by Prof. Elbarbary in Cairo. We are experienced in coordinating care for international families and can help plan surgery timing around travel. A telemedicine consultation can be arranged first so that you can share medical records and photographs and receive a clear recommendation before committing to travel.

My son had a previous repair that didn’t work. Can Prof. Elbarbary help?

Re-do (redo) hypospadias — surgery to correct a failed previous repair — is one of the most technically demanding procedures in paediatric urology. Prof. Elbarbary has extensive experience with revision cases, including the use of buccal mucosa grafts for cases where urethral tissue is scarce. Please bring all previous operation reports and photographs to the consultation so that the anatomy can be properly assessed.

Is it safe to wait until my son is older?

The ideal surgical window is 6–18 months. Beyond that, surgery is still safe and effective, but younger children heal more easily and the tissues are more pliable. There is no medical benefit to waiting beyond the recommended age range — and delaying until school age can add psychological difficulty for the child. If your son is older than 18 months and has not yet had surgery, we recommend booking a consultation soon rather than deferring further.

How long will we need to stay in Cairo?

For a single-stage repair, most families need to be in Cairo for 7–10 days: 1–2 days for pre-operative assessment, 1 night (or day case) for surgery, and a return visit for catheter removal at day 5–10. For a two-stage repair, each stage requires a similar stay. We will give you a clear timeline specific to your child’s case at the consultation.

What is the consultation like?

At the first consultation, Prof. Elbarbary will take a full history, examine your son, and review any previous investigations. He will explain exactly what type of hypospadias is present, whether surgery is recommended, which technique will be used, what the expected outcome is, and what risks are involved. You will have plenty of time to ask questions — in Arabic or English — before making any decision.

About Professor Mohamed Elbarbary

Professor Mohamed Elbarbary, FRCSEd is a Professor of Paediatric Surgery at Cairo University’s Faculty of Medicine, Kasr Al-Ainy — one of the most respected medical institutions in the Arab world. With over 36 years of specialised experience in paediatric surgery, he has performed hundreds of hypospadias repairs across the full spectrum of complexity, including primary repairs, two-stage procedures, and revision surgery.

In 2026, Professor Elbarbary received the Fellowship of the Royal College of Surgeons of Edinburgh (FRCSEd) ad hominem — an honour awarded by distinction to surgeons who have made an outstanding contribution to their specialty. He remains committed to providing families across Egypt and the wider Arab world with access to world-class paediatric surgical care.

• Professor of Paediatric Surgery — Cairo University

• Fellow, Royal College of Surgeons of Edinburgh (FRCSEd 2026)

• 36+ years of clinical experience in paediatric surgery

• Specialised in hypospadias, inguinal hernia, undescended testis, and other paediatric urological and abdominal conditions

• Arabic and English spoken

Other Conditions We Treat

Prof. Elbarbary provides comprehensive paediatric surgical care. Related conditions frequently treated alongside or following hypospadias include:

• Undescended Testis (Cryptorchidism)

• Inguinal Hernia in Children

• Circumcision

• Diaphragmatic Hernia

• Branchial Cysts and Sinuses

• Thyroid Cysts in Children

• GERD and Acid Reflux in Infants

drmohamedelbarbary.com | Cairo University — Kasr Al-Ainy | FRCSEd 2026