Duke Children's pediatric urologists treat all types of hypospadias including complex hypospadias. We offer the highest level of care, achieve excellent results, and give your child the best possible start to help them feel confident and healthy.

Hypospadias Care Based on Your Child’s Needs

Hypospadias is a birth defect in boys in which the opening of the urethra -- the tube that urine flows through -- is on the underside of the penis, rather than at the tip. It usually affects the appearance of the foreskin and the direction of the urine stream; it can also cause the penis to curve downward. In severe hypospadias, it can be difficult to tell whether the child has male or female genitals.

Mild hypospadias doesn’t necessarily need surgery. This may be the case if normal urinary and sexual function aren't affected, and the difference in appearance is minor. In some instances, parents wait until the child is older to have surgery. Waiting makes no difference in surgery success rates.

When surgery is necessary, it is usually done between six and 18 months of age, when anesthesia is safe and the penis has completed its initial growth phase. Our pediatric urologists have advanced experience treating hypospadias, so we explain all your options and offer guidance to help you decide what’s right for your son.

Choosing a Center for your Child’s Hypospadias Surgery

Performing the surgery correctly the first time prevents the need for multiple corrective procedures. That’s why it’s so important to work with pediatric urologists who have experience treating hypospadias.

  • Our pediatric urologists treat a large number of severe hypospadias for a center of our size while maintaining a very low complication rate -- less than 5 percent for distal hypospadias and less than 10 percent for proximal hypospadias. That’s among the lowest in the country. 
  • Our pediatric urology program is the only one in North Carolina to rank among the nation’s best by U.S. News & World Report every year.
  • Our experienced surgeons and pediatric anesthesiologists make surgery as safe and comfortable as possible for your child. In fact, Duke Children’s is one of only seven hospitals in the U.S. verified as a level I children's surgery center by the American College of Surgeons. This Level I designation recognizes our commitment to providing the safest and highest-quality surgical care to our young patients.
  • When your child’s sex is unclear or ambiguous, your child’s care team will include a pediatric urologist and gender specialists to ensure your child has comprehensive care, including psychological support for children and parents. Our gender care team includes pediatric endocrinologists, social workers, and behavioral health counselors. We work collaboratively with other specialists in fertility, voice care, and other areas to support your child’s overall health and development.
  • Our pediatric urologists care for children of all ages, from infants to older kids. We repair unsuccessful surgeries that were completed elsewhere and work with young adults who decide they want corrective surgery.
  • No matter your child’s age, we design a personalized care plan that includes emotional support and assistance from our dedicated team.
  • Surgery can be frightening for kids. Our child life specialists can help explain the surgery so they know what to expect and help them feel better through play learning, fun activities, and encouragement. 


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