Familial hypospadias

Consult with your child's primary care doctor and urologist about the best treatment options for him. Depending on the location of the hypospadias, surgery may or may not be needed. About 60 to 65% of all cases of hypospadias are of the subcoronal type. In general, the subcoronal type of hypospadias does not cause long term issues with urinating while standing up, or with maintaining an erection for intercourse, and surgical correction may not necessary. With more severe cases of hypospadias, especially if the penis is also curved (called chordee), surgery may be necessary and important for normal penile function.

If surgery is needed to correct the defect, it is usually performed when the individual is between the ages of 3 and 18 months but can be done at any age after that. Depending on what repairs are needed, the surgery may be done in stages. It may be important to postpone circumcision until after the hypospadias is repaired, as the foreskin may be needed to help with reconstruction.

Surgical repairs can include extending or creating the urethra, moving the opening of the urethra to the right place, correcting the curve in the penis, and/or circumsizing or reconstructing the skin around the opening of the urethra (the foreskin). It may also be important to postpone circumcision until after the hypospadias is repaired, as the foreskin may be needed to help with reconstruction. The goal of surgery is to prevent complications with urination and/or sexual intercourse. A successful repair should last a lifetime.

Your doctor and surgeon should review the possible risks with you prior to surgery based on your specific case. The most common complications of surgery for hypospadias include infection, fistula, and strictures. A fistula can occur if a hole develops along the pathway of the repair allowing for leakage of urine. A stricture is a scar that can form, causing the urethra to become narrower than normal. With good surgical technique and effective post-operative care, these complications can be minimized.