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.
Hypospadias surgery repairs the urethra and relocates the opening to the tip of the penis. The actual procedure will vary depending on where the urinary opening is on the penis and what needs to be repaired. If curvature of the penis is present, that will be corrected at the same time. Your pediatric urologist will explain the procedure and what to expect during recovery. Most hypospadias surgeries are performed as outpatient procedures, with no overnight hospital stay necessary. Often, a small tube (catheter) will be left in place for a few days after surgery to allow proper healing. This tube will simply drain into the diaper and can be removed in clinic.
We know how difficult it is when your child is in pain, so we take pain control very seriously. After surgery, your child will return home with a pain regimen that makes the healing process as comfortable as possible. The surgical care team will give you detailed instructions about how to give your child pain medicine safely to prevent pain or relieve it as much as possible.
Our urologists and gender-care team offer comprehensive treatment, counseling, and emotional support to young adults who are concerned about appearance, urinary stream, fertility, or sexual function. We also help young adults who had surgery as infants and are unhappy with the result.
Our pediatric urologists specialize in repairing severe hypospadias that may require multiple surgeries -- whether it’s to repair an earlier, failed procedure or because your child has very complex anatomy. We develop a surgical treatment plan to meet your child’s needs and offer support throughout the process. Complication rates from this type of complex repair can be as high as 50 percent to 80 percent at some centers, but our complication rates are less than 10 percent for even the most difficult surgeries.