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How is Hypospadias Treated?

Hypospadias
Hypospadias
Image © 2003 Fairman Studios, LLC.

Hypospadias is fixed with surgery. Surgeons have been correcting hypospadias since the late 1800s. More than 200 types of operations have been described. But since the modern era of hypospadias reconstruction began in the 1980s, only a handful of techniques have been used by pediatric urologists.

The goal of any type of hypospadias surgery is to make a normal, straight penis with a urinary channel that ends at or near the tip. The operation mostly involves 4 steps:

  • straightening the shaft
  • making the urinary channel
  • positioning the meatus in the head of the penis
  • circumcising or reconstructing the foreskin

Hypospadias repair is often done in a 90-minute (for distal) to 3-hour (for proximal) same-day surgery. In some cases the repair is done in stages. These are often proximal cases with severe chordee. The pediatric urologist often wants to straighten the penis before making the urinary channel.

Surgeons prefer to do hypospadias surgery in full-term and otherwise healthy boys between the ages of 6 and 12 months. But hypospadias can be fixed in children of any age and even in adults. If the penis is small, your health care provider may suggest testosterone (male hormone) treatment before surgery.

A successful repair should last a lifetime. It will also be able to adjust as the penis grows at puberty.