Hypospadias repair

What is hypospadias repair?

Hypospadias is a difference some boys are born with, where the opening of the urethra (the tube that carries wee) is on the underside of the penis rather than at the very tip. The penis may also curve downwards, and the foreskin is often incomplete. It is common, affecting roughly three in every 1000 boys, and it is not caused by anything a parent did.

Hypospadias repair is an operation that aims to move the opening to the tip, straighten any bend, and tidy or rebuild the foreskin where possible. The goal is a penis that looks more typical, lets your child wee in a normal stream while standing, and works normally in later life.

Mild (distal) hypospadias, where the opening is near the tip, is usually fixed in a single operation. More severe (proximal) hypospadias may need two operations a few months apart. Your surgeon will explain which your child needs and why.

Not every boy with very mild hypospadias needs surgery. If the opening is close to the tip, the penis is straight, and weeing is normal, an operation may not be necessary, and your surgeon should discuss whether watching and waiting is reasonable.

Types & techniques

There isn't one single operation. The right approach depends on you — which is something to discuss with your surgeon.

Options at a glance

These are the main approaches described in this guide. The right option depends on the diagnosis, your goals and what your clinician thinks is safe.

Preparing for your surgery

• Meet the surgeon who will operate, and ask which technique your child needs, whether it is one or two stages, and what the foreskin will look like afterwards.
• Follow the fasting (nil by mouth) instructions exactly; you will be told when your child must stop milk, food and clear fluids before the anaesthetic.
• Tell the team about any bleeding tendency, regular medicines, allergies, or previous problems with anaesthetics in the family.
• Plan for around a week off nursery or school, and arrange help at home for the first few days while you manage the catheter and dressing.
• Stock up on the painkillers, any antibiotic and bladder-calming medicine you are sent home with, plus plenty of nappies (a 'double nappy' is often used to hold the catheter).
• Bring familiar comforters, and ask to stay with your child until they go to sleep and to be there as they wake up.
• Make sure you have the ward or nurse specialist contact number before you go home.

What happens

The operation is done under general anaesthetic, so your child is fully asleep and feels nothing; a local anaesthetic block is often added for comfort afterwards. It usually takes between one and three hours, depending on how much rebuilding is needed.

The surgeon straightens the penis if it curves, builds a new channel to bring the opening to the tip, and reshapes or removes the spare foreskin. Fine dissolvable stitches are used. A small soft tube (a catheter or stent) is usually left in to drain wee while everything heals, and a protective dressing is wrapped around the penis.

Many boys go home the same day with the catheter and dressing in place. After a more complex or two-stage repair, your child may stay overnight. You will be shown how to give medicines, keep the area clean, and care for the catheter before you leave.

Is this operation right for me?

A good consultation should explore whether it's the right choice for you now — including reasons to wait or consider something else.

Before you decide

Use this as a shared-decision checklist. The aim is not just “can this be done?”, but whether it is right for you, now, with the risks and alternatives clearly understood.

Anaesthetic choices

The safest option depends on the operation, your health, the facility and your surgeon/anaesthetist. Ask what is planned and why.

The most important thing to understand is that further surgery is fairly common in hypospadias repair, especially for more severe cases, and is not a sign of failure. Ask your surgeon how many of these operations they do, their own fistula and reoperation rates, whether your child's repair is one or two stages, and exactly what to watch for once the catheter is out.

Published figures to discuss

Complication and reoperation rates depend heavily on how severe the hypospadias is, the technique used, and the surgeon's experience. Rates are higher for proximal (severe) repairs than for distal (milder) ones, and the figures below come from large reviews of milder repairs, so your child's individual risk may differ.

These are literature figures, not a personalised prediction. Your own risks and likely benefits depend on your circumstances, your health, and how your care is carried out and followed up.

Recovery — what to expect, and when

Most boys are back to themselves within a week or two. The first job at home is keeping your child comfortable and the catheter and dressing in place until the team removes them.

• A swollen, bruised penis that looks worse before it looks better in the first week
• Blood-stained oozing onto the dressing and spotting in the nappy
• Stinging or spraying with the first wees after the catheter comes out
• Loose stools while taking antibiotics
• A grumpy, clingy child for a few days after the anaesthetic

Aftercare

• Give pain relief regularly for at least the first couple of days, not just when your child seems sore.
• Give the antibiotic and any bladder-calming medicine (such as oxybutynin) exactly as prescribed, and watch for constipation.
• Keep the catheter secured, unkinked and draining; use the double-nappy method you were shown.
• Avoid baths until the catheter and dressing are out; follow the team's advice on gentle washing.
• Keep your child off straddling toys, sport and trampolines for about 6 weeks.
• Encourage fluids so wee flows well and the catheter does not block.
• Keep all follow-up appointments, including any later review around puberty if advised.

• Painkillers (paracetamol, and ibuprofen if advised) at home
• Antibiotics and bladder-calming medicine collected
• Plenty of nappies for the double-nappy method
• Time off nursery or school booked (about a week)
• Help arranged at home for the first few days
• Ward / nurse specialist phone number saved
• Follow-up appointment in the diary

Scars and how they heal

Stitches are dissolvable and the cuts are placed to heal as discreetly as possible along the underside of the penis. There is usually a fine scar line, and the foreskin will either be rebuilt or look circumcised depending on the technique used. Scars in young children generally settle and fade well over many months.

⚠ Get urgent help if…

• No wee draining from the catheter for several hours (a possible blockage) — contact the team
• The catheter falls out before the planned removal date
• Bleeding that soaks through the dressing or does not stop
• A high temperature, or the wound becoming hot, red, swollen or smelly (signs of infection)
• Severe pain not controlled by the prescribed painkillers
• Repeated vomiting, or your child becoming floppy, drowsy or not feeding/drinking
• After the catheter is out: not passing wee at all, or only dribbling with a very swollen tummy

Who to contact: your surgeon or clinic first (keep their number to hand). For urgent advice when you can't reach them, call NHS 111. In an emergency, call 999.

General guidance — it doesn't replace the specific advice your surgeon gives you.

Results & realistic expectations

A good result is a penis that looks more typical, with the opening at or near the tip, a straight shape, and a forward wee stream your child can usually direct while standing. The full picture is clearer once the dressing and catheter are out and swelling has settled, which is why a clinic review at a few months matters.

No surgeon can promise a perfect result first time, and outcomes are generally better for milder hypospadias than for severe forms. Some boys need one or more further operations, and a few issues only show up years later, so your surgeon should explain realistic expectations and long-term follow-up rather than guarantee an outcome.

A well-healed repair is usually long-lasting. However, the penis keeps growing through childhood and puberty, and occasionally a curve returns or a narrowing develops as it grows. Because of this, some teams arrange a review around puberty, especially after a more complex repair, to check the wee stream and appearance as your child matures.

Combining with other procedures

Hypospadias repair often includes straightening the penis and reshaping or removing the foreskin at the same time, so a separate circumcision is usually not needed. If your child has another condition such as an undescended testis, the surgeon will discuss whether anything else is best dealt with at the same operation.

Follow-up & long-term care

Most children are seen at around 5 to 10 days to remove the catheter and dressing, then again at roughly 3 to 6 months to check healing, appearance and the wee stream. Further reviews depend on how the repair heals, and some boys are seen again around puberty. You should always be given a clear route to contact the team between appointments.

Revision and secondary surgery reality

• Further surgery is a normal part of hypospadias care, particularly for severe cases, and may be planned (two-stage) or needed for a complication.
• A fistula or narrowing is usually repaired a few months later once tissues have healed and settled.
• Some children need more than one further operation over the years.
• Problems can appear late, including as the penis grows in puberty, so long-term follow-up is part of a good service.

Ask your surgeon for their own revision rate, what counts as a revision, and what is included in the written aftercare policy.

What good aftercare looks like

• Clear written instructions on catheter care, the double-nappy method, medicines and when to seek help.
• A named contact (nurse specialist or ward) reachable in and out of hours for the first weeks.
• A planned visit to remove the catheter and dressing, and a later review at a few months.
• An agreed plan for managing any fistula or narrowing, and longer-term follow-up where needed.

What affects the cost

Costs vary a great deal between people and providers, and we don't publish prices. What matters is understanding what drives the cost and making sure your quote is complete. The main things that affect it:

• Whether the repair is one-stage or two-stage (two operations)
• Severity of the hypospadias and whether the penis needs straightening
• Surgeon's fee and the experience of the paediatric urologist
• General anaesthetic and the paediatric anaesthetist's fee
• Theatre and facility costs, plus any overnight stay
• Follow-up appointments and management of any complication such as a fistula
• Dressings, catheter and take-home medicines

• The surgeon's fee and the anaesthetist's fee
• Theatre/facility fee and any overnight stay
• Whether the price covers one stage or both stages of a two-stage repair
• What is included for follow-up appointments and dressing/catheter removal
• What happens, and what it would cost, if a complication such as a fistula needs further surgery
• Take-home medicines and dressings
• The cancellation and rebooking policy

On the NHS? Hypospadias repair is routinely available on the NHS through specialist paediatric surgery or paediatric urology; private care is sometimes used for choice of surgeon or timing rather than because the NHS does not provide it.

You're entitled to your total cost in writing — including aftercare and any revision — before you decide.

Consent traps and marketing red flags

These are not small details. They are often where patients lose choice, time to reflect, or realistic expectations.

Choosing a surgeon safely

• Check your surgeon is on the GMC Specialist Register for this area.
• Make sure they practise at a CQC-registered location, and look for membership of bodies like BAAPS or BAPRAS.
• You're entitled to a two-stage consent process with time to reflect (a cooling-off period). The surgeon who will operate must consent you — not a salesperson.
• Be wary of pressure: time-limited offers, discounts or deposits taken before you've had time to think are red flags, not bargains.
• You're entitled to your total cost in writing — including aftercare and any revision — before you decide.

How Vuemedics verifies every consultant →

Take this to your consultation. A good surgeon will welcome every one of these.

• Is my child's hypospadias mild or severe, and will it be a one-stage or two-stage repair?
• Which technique will you use, and will the foreskin be rebuilt or look circumcised?
• What are your own fistula and reoperation rates for repairs like my child's?
• What type of catheter or stent will be used, and how long will it stay in?
• Exactly what should I watch for once the catheter is out, and who do I call?
• Will my child need a review around puberty?
• Are you on the GMC Specialist Register for this area, and which Royal College or professional body are you a member of?
• Will you be the surgeon who carries out my operation, and who looks after me afterwards?
• What are the risks for someone like me, and how often do your own patients have a problem or need it repeated or redone?
• What does a realistic result look like — and what can this operation not achieve?
• What are my options, including waiting, doing nothing for now, or choosing a different approach?
• Can I have written information, results and aftercare instructions in a format I can use, including any accessibility or communication support I need?
• What is the total cost in writing, including any follow-ups, and how much time do I have to decide?

Find a verified surgeon for hypospadias repair

Every consultant is GMC-checked and independently reviewed. Search by postcode and distance, or switch to a map. Ordered by rating, relevance and recency — never by who pays.

How we made this page

Medically reviewed by a GMC-registered consultant. Written in plain English, checked against NHS, NICE, GMC and relevant Royal College / specialist-society guidance, and kept under review. No clinic paid to appear on this page, and we publish no pricing. This is general information to help you prepare — it is not a substitute for advice from your own clinician. How we review our guides →

Source hierarchy: UK regulator and NHS/NICE guidance first, then relevant Royal College or specialist-society guidance, then peer-reviewed evidence for procedure-specific figures where available.

Sources & standards: GOSH — After hypospadias repair Cambridge University Hospitals — Hypospadias (parent information) Sheffield Children's — Care after hypospadias surgery Leeds Teaching Hospitals — Hypospadias repair Complications after distal hypospadias repair — meta-analysis (PMC) British Association of Paediatric Surgeons (BAPS)

Reviews reflect patients' experience of care, not clinical outcomes. For procedure volumes and outcome data see PHIN.

Last medically reviewed 2026-09-21. Spotted something wrong or out of date? Report an error in this guide.