Hypospadias Repair

Hypospadias repair is a surgery that lengthens the tube (urethra) from the bladder, so it comes out at the penis tip. If there is a bend in the penis (chordee), the surgeon will straighten it during the repair.

We created videos to explain how to care for your child after surgery. You can search for these titles on YouTube. You may need to login due to age restrictions.

• “How to Care for Your Child After Urologic Surgery”
  youtube.com/watch?v=epLQn5D62wk

• “How to Care for Your Child After Penile Surgery” vimeo.com/1045146715/6dbed51e58

• When fully awake, your child may have clear liquids, like water, apple juice, Jell-O, or Popsicles.
• Nausea and throwing up (vomiting) are common after surgery. If this happens, give your child a small amount of clear liquids at a time.
• If your child is not having a stomachache or throwing up and is fully awake, your child can start their regular diet.

• After the surgery, your child may have a dressing (bandage) on the penis.
• There will be a small, soft tube (catheter) in the penis, which will drain their pee (urine). This is secured in place with stitches (sutures). We will remove the catheter in clinic after the surgery.
• The area around the incision will be swollen and red. You may also notice some bruising, yellow crusting or scabbing. This will get better with time.
• If there is active bleeding, or if you find your child has a blood-soaked diaper or underwear, apply pressure to the penis for 5 minutes.
• If the bleeding does not stop after 5 minutes, call us and continue to apply pressure for another 5 minutes.
• If bleeding continues after 10 minutes of applying pressure, go to the Seattle Children’s Emergency Department.
• Before and after the dressing falls off, put between a teaspoon and a tablespoon of petroleum jelly (Vaseline) all over your child’s penis with each diaper change (about 5 times per day) for at least 2 weeks.

• This dressing helps to reduce the risk of bleeding and swelling after surgery.
• This will fall off on its own some time from 2 to 14 days after surgery. You do not need to remove it.
• If the dressing becomes dirty with poop (stool), do your best to clean off the poop. You may use water to clean the poop off of the dressing, even if it is less than 48 hours after surgery. If the dressing gets poop on it or falls off early, do not replace it.

• The catheter is held in place by a stitch at the tip of the penis.
• Pee (urine) will drip continuously from the catheter into a double diaper. We will show you how to double diaper before you go home.
• The catheter may have a cap on the end. Please make sure the cap is off, and the catheter is draining into the diaper.
• If urine is not draining and your child’s diaper is dry for 4 hours, make sure the catheter is not bent (kinked). If urine is still not draining, call the urology clinic.
• The urine may be light pink, and you may see spots of blood in the diaper.

• Your child will wear a normal sized diaper on the inside.
• On the outside, your child will wear a diaper 1 size larger.
• The catheter will drain into the outer diaper, so the catheter does not get dirty if your child poops on it.

Your child should:

• Rest the day of surgery.
• Avoid rough play, climbing, contact sports and pressure on the area from straddle toys (bicycles, jumpers, etc.). A good rule for activity is for them to keep both feet on the ground at the same time for 2 to 3 weeks after surgery.

• It is important for your child to poop after surgery.
• Some of the medicines your child may take (such as oxybutynin) can cause trouble pooping (constipation).
• If your child is straining or has not pooped for 2 to 3 days after surgery, give plenty of water, juices, and high fiber foods like fruits and vegetables. See our handout “High Fiber Foods” seattlechildrens.org/pdf/PE592.pdf
• If your child has not pooped for 3 days, call the urology clinic. We may prescribe a stool softener.
• If your child’s poop gets on the incision, wash it off with water (do not use soap).

• After a surgery, your child will likely feel pain. You know your child best. We encourage you to take an active part in your child’s recovery by talking with your care team about options for your child.
• We may prescribe acetaminophen (Tylenol), ibuprofen (Advil, Motrin) for pain. You will be given instructions on dosing and timing when you are getting ready to go home. See our handout “Acute Pain.”
  seattlechildrens.org/pdf/PE503.pdf
• In addition to medicine prescribed for pain, we will work with you to create a plan that encourages coping activities. Help your child get better, faster with good pain treatment.
• See our handout “Soothing Your Baby: In the Hospital and at Home.”
  seattlechildrens.org/pdf/PE593.pdf

• Antibiotic: Your doctor may prescribe this to help prevent infection while the catheter is in place. Stop giving this medicine after we remove the catheter.
• Oxybutynin (Ditropan): Your doctor may prescribe this to prevent bladder spasms. Bladder spasms are muscle cramps in the bladder caused by irritation from the catheter. Signs that your child may be having a bladder spasm are crying, pulling knees to the chest or urine leaking around the catheter. Do not give oxybutynin the day of the catheter removal.
• Stool softener: Your doctor may prescribe a stool softener to prevent or help with constipation.

• We will remove the stitch holding the catheter in place in the urology clinic 2 to 10 days after surgery.
• We will monitor your child in the Urology clinic after surgery. The surgeon will discuss your child’s follow-up plan with you.

Urology Clinic
Monday to Friday: 206-987-2509
Nights, weekends and holidays: call 206-987-2000 and ask for the urology resident on call.

Call if your child has any of the following:

• Fever higher than 101.5° F (38.6° C)
• Increased redness or swelling that spreads up into the stomach area
• A lot of bleeding that doesn’t stop after you apply pressure for 5 minutes
  
  • If bleeding doesn’t stop after applying pressure for 10 minutes, go to the Seattle Children’s Emergency Department.
• Pain not controlled by the medicine prescribed
• Cannot pee in 8 to 12 hours after surgery or urine is not draining from the catheter for more than 4 hours
• Throwing up (vomiting)
• The catheter comes out

Send MyChart messages for non-urgent questions.