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Infants with hypospadias should not be circumcised. The foreskin should be preserved for use in later surgical repair.
Surgery is usually done before the child starts school. Today, most urologists recommend repair before the child is 18 months old. During the surgery, the penis is straightened and the hypospadias is corrected using tissue grafts from the foreskin. The repair may require multiple surgeries.
Results after surgery are typically good. In some cases, additional surgery is needed to correct fistulas or a return of the abnormal penis curve.
If hypospadias is untreated, a boy may have difficulty with toilet training and problems with sexual intercourse in adulthood. Urethral strictures and fistulas may form throughout the boy's life, requiring surgery.
Typically a child is diagnosed with hypospadias shortly after birth. Call your health care provider if you notice that your son's urethral opening is abnormally located or that his penis becomes curved during erection.
Borer JG, Retik AB. Hypospadias. In: Wein AJ, ed. Campbell-Walsh Urology. 9th ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 125.
Elder JS. Anomalies of the Penis and Urethra. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, eds. Nelson Textbook of Pediatrics. 18th ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 544.