Hypospadias surgery for children

Watch Prof. Dr. Mohamed Elbarbary explain the surgery:

Many parents believe that hypospadias surgery is limited to closing the lower opening and creating a new anterior opening. And this couldn’t be farther from the truth. What we actually do is complete the missing part of the urethra, using tissues from the organ itself in most casses, or tissues that are extracted from another part of the child’s body in complex cases. One of the possible complications is what is known as urinary fistula, which is the leakage of some urine between the sutures. and it is not dangerous in most cases and is easily treatable until the child returns to their normal state.

Hypospadias surgery in children is performed to treat a condition some male children are born with, in which the urethral opening is located on the underside of the penis rather than at its tip.

Performing this surgery on the child is necessary to ensure they regain the ability to urinate normally and correct the congenital penile deformity.

The following are important details about hypospadias surgery in children, starting from preparation, through its steps, and finally to the recovery stage.

Before surgical hypospadias treatment

Hypospadias treatment is surgery only, but before the procedure, the child must undergo comprehensive medical examinations to confirm surgical readiness and the absence of any infections or conditions that may affect the surgical outcomes.

These examinations include:

• Clinical examination to assess the condition of the penis and determine the exact location of the urethral opening, and to detect any curvatures that may be associated with hypospadias.
• Imaging examinations to check for any urinary tract obstructions.

In addition to the above, the surgeon asks the child’s parents about the strength and accuracy of their urination

Steps of hypospadias surgery in children

Doctors recommend that the child’s age at the time of hypospadias surgery be between 6 and 12 months, provided they have not previously undergone circumcision.

Hypospadias surgery in children is considered a delicate procedure, whose steps include:

• General anesthesia to ensure the child feels no pain during the surgery (under the supervision of an anesthesiology consultant specialized in pediatric and neonatal cases).
• Making precise incisions around the tissues surrounding the urethra to access the urethral opening and correct its position.
• Reconstructing the urethra by creating a small tube at the tip of the penis and connecting it to the urethral opening, then correcting the position of this opening and repositioning it to the tip of the penis.
• Correcting any penile curvatures (if present).
• Reconstructing the skin around the urethral opening to improve the external appearance of the penis.
• Placing a catheter upon completion of the surgical steps, to ensure easy urine drainage and maintain the shape of the new urethra.
• Closing the incisions and applying medical dressings to maintain wound cleanliness.

Learn about: The best pediatric surgeon

How long does the hypospadias surgery for children take?

Hypospadias surgery in children typically takes about an hour or slightly more, with the duration depending on the complexity of the case. For example, first-degree hypospadias surgery, performed on children whose urethral opening is located just below the tip of the penis, has a relatively short duration due to the simplicity of the urethral repair procedures required.

as for more complex hypospadias cases, in which the urethral opening is at the end of the penis, the surgery will take longer.

After the surgery: Home care

After the surgery, the child is required to stay at the hospital for a day or two to supervise his condition and ensure its stabilization.

meanwhile, the parents receive instructions about how to take care of the wound and replace the bandages, in addition to how to deal with the urinary catheter to make sure the operation site does not get infected.

And the surgeon will most likely prescribe some pain killers, and sometimes antibiotics to prevent infection, and the parent will be advised to make some follow-up visits at the clinic during the first recovery days to ensure the completeness and correctness of the healing of the tissues, and to ensure the child’s health.

Expected recovery period after the surgery

Recovery periods after the hypospadias surgery in children range -approximately- between two weeks to one month. And this is required for the tissue to heal, and for the body to return to its natural condition.

Success rate of the hypspadias surgery in children

Surgical hypospadias treatment is considered a successful therapeutic approach, as the success rate of hypospadias surgery in children reaches 90-95% when performed by experienced and skilled pediatric surgeons.

Are there any complications after the hypospadias surgery in children?

Despite the hypospadias surgery as a treatment being considered a safe operation, some complications may appear including:

• Urethral narrowing due to scar tissue formation around the urethra.
• Urine leakage.
• Wound infection.

Therefore, it is important to follow up the child’s condition with an experienced paediatric surgeon to ensure the surgery is performed by skilled hands using the latest precision instruments, as this raises the success rates of hypospadias surgery in children and minimizes the chances of complications.

Read about: Complications of hypospadias surgery in children

Important Advice:

After hypospadias surgery in children, it is advised to maintain cleanliness of the surgical area, and it is preferable to use soft diapers to maintain the child’s comfort and avoid pressure on the wound.

Parents must monitor any abnormal changes or symptoms that may appear in the child after surgery, LIke:

• Bleeding
• Unfamiliar discharge from the wound.
• High body temperature.
• Hardship in urinating after the catheter is removed.
• Increased redness or swelling in the wound area.

In case any of these symptoms appear, the doctor must be consulted immediately to take the necessary medical action.

In summary ..

Hypospadias surgery in children is a necessary therapeutic procedure that ensures a normal life for the child; performing it at the appropriate age will help them urinate normally and ensure healthy development of the urinary system and the penis.

If you have any inquiries about hypospadias treatment, or wish to check on your child’s condition, you can book an appointment with Dr. Mohamed El-Barbary — Professor of Pediatric, Neonatal, and Laparoscopic Surgery at Abu El-Reesh University Hospital at Kasr Al-Ainy — through the contact details available on our website, to receive trusted medical consultation.