Hypospadias Repair: Surgery, Recovery & Risks Explained
Updated: 6 days ago
Written and medically reviewed by Dr. Baraa Alnahhal, MD · Last reviewed: October 2026 · How we review
Quick Answer: What is hypospadias repair?
Hypospadias repair is a surgery that moves the urethral opening to the tip of the penis, usually between 6 months and 2 years of age. Mild cases need one operation; severe penoscrotal cases need two, about six months apart. Most children go home the same day and fully recover in about six weeks. [1]
What the research says
Distal repairs have the lowest complication rates. A meta-analysis of 49 studies (4,675 patients) of the tubularized incised plate repair found fistula rates of 5.7% for primary distal hypospadias, 10.3% for primary proximal, and 15.5% for repeat (secondary) repairs; re-operation rates were 4.5%, 12.2% and 23.3%. (Pfistermuller et al., J Pediatr Urol, 2015) [2]
Severe (proximal) cases carry much higher risk. Across four common techniques for proximal hypospadias, overall complication rates ranged from 32% to 49%, and fistula rates from 13% to 23%. (Cousin et al., J Pediatr Urol, 2022) [3]
Testosterone before surgery helps growth and may lower fistula risk. A meta-analysis of 32 studies found pre-surgery testosterone increased penile length by 9.34 mm and glans width by 3.26 mm; it did not change the overall complication rate but lowered fistula risk (RR 0.52). (Do et al., World J Mens Health, 2023) [4]
Key takeaways
Hypospadias repair is a common, major surgery with a high success rate; most repairs last a lifetime. [1]
The usual timing is 6 months to 2 years after birth, and the decision to operate belongs to the parents. [1]
Recovery is about six weeks, with the catheter (stent) staying in place for up to two weeks. [1]
Fistula — a small hole that leaks urine — is the complication to know about, and it can appear months or years later. [1][2]
What is hypospadias, and why is it repaired?
Hypospadias is a condition present at birth in which the urethra (the tube that carries urine and semen out of the body) does not fully develop, so its opening — the meatus — sits on the underside of the penis instead of at the tip. [1] Learn more in our full guide to hypospadias symptoms, causes and treatment.
The opening can form in three main places: [1]
Location | Medical name | How common |
Near the head of the penis | Subcoronal | Most common (mild) |
Along the shaft | Midshaft | Less common |
Where the penis meets the scrotum | Penoscrotal | Least common (severe) |
About 1 in every 250 to 300 newborns has hypospadias, making it one of the most common conditions present at birth in boys. [1]
Some children also have a curved penis (chordee) or penoscrotal transposition, where the scrotum sits above the penis. Surgeons may correct these during the same repair. [1]
Is hypospadias repair necessary?
Hypospadias repair is not always necessary; children with minor hypospadias may not need surgery at all. [1]
The main goals of repair are to make urinating and, later in life, ejaculating easier and more comfortable. [1] The benefits include: [1]
Moving the urethral opening to the tip of the penis for normal urination and ejaculation
Straightening the penis
Improving appearance
What is the best age for hypospadias surgery?
The best age for hypospadias surgery is usually between 6 months and 2 years after birth. [1]
Timing matters for another reason: when the repair happens during or after puberty, the penis may become shorter. [1]
How should you prepare your child for hypospadias repair?
Preparing for hypospadias repair starts with a visit where the care team checks your child's general health, takes vital signs and examines the penis. [1] During this visit, they will:
Find exactly where the opening is
Ask how strong the urine stream is, which direction it flows, and whether it sprays or leaks
Check how much the penis curves during an erection
Order a cystoscopy or urethrogram, if needed, to look for blockages
Tell the team about:
All medicines and supplements — aspirin, anti-inflammatory drugs and some herbal supplements raise bleeding risk
All allergies, including to medicines, iodine, isopropyl alcohol, latex and foods
Testosterone injections: In severe cases, the surgeon may recommend testosterone injections before surgery. They safely increase the length and width of the penis, which improves the odds of a successful repair. [1][4]
Fasting: Follow the food and drink instructions exactly. A full stomach can lead to vomiting under anesthesia and breathing food or fluid into the lungs (aspiration), which can cause pneumonia. [1]
Staying calm: Young children pick up on your body language, facial expressions and tone of voice. The calmer you are, the more relaxed your child will be. [1]
How is hypospadias repair performed?
Hypospadias repair is performed under general anesthesia by a pediatric team that includes a pediatric urologist, a pediatric anesthesiologist and a pediatric nurse, so your child is asleep and feels no pain. [1]
Step by step: [1]
The urologist removes a section of foreskin.
The foreskin is shaped into a tube and attached to the urethra to make it longer.
The opening is moved to the tip of the penis.
A soft catheter (stent) is placed in the urethra to hold its shape and drain urine. It can stay in for up to two weeks.
The cuts are closed with dissolvable stitches, which dissolve within about two weeks.
The surgeon may perform extra repairs at the same time: [1]
Procedure | What it does |
Urethroplasty | Rebuilds the urethra so urine and semen flow as far forward as possible |
Meatoplasty (glanuloplasty) | Creates a new opening and reshapes the head of the penis around it |
Scrotoplasty | Repairs the scrotum |
What is the difference between one-stage and two-stage hypospadias repair?
One-stage hypospadias repair is a single surgery used for mild cases, while two-stage repair is two surgeries used for penoscrotal hypospadias. [1]
One-stage repair | Two-stage repair | |
Used for | Mild hypospadias | Penoscrotal (severe) hypospadias |
Number of surgeries | One | Two |
Time between surgeries | — | Usually about 6 months |
Tissue used | Foreskin | May include skin from inside the mouth |
How long does hypospadias surgery take?
Hypospadias surgery usually takes up to two to three hours. [1]
Most repairs are outpatient procedures. After surgery, the stitches are bandaged, the stent is secured, and your child wakes up in a recovery room. Once the team confirms your child is stable, you can usually go home the same day, often with pain medicine. [1]
How long is recovery after hypospadias repair?
Recovery after hypospadias repair takes about six weeks for many children, with swelling and bruising usually fading after about two weeks. [1] Expect your child to sleep more for the first several days — sleep helps healing. [1]
Time after surgery | What to expect |
Day of surgery | Most children go home the same day |
First week | Rest at home; no school or daycare for at least a week, or until the stent is removed |
Up to 2 weeks | Stent removed; stitches dissolve; swelling and bruising fade |
2–3 weeks | Infants and toddlers return to many activities |
3+ weeks | Older children can return to sports, cycling and active play |
About 6 weeks | Many children are fully recovered |
How do you care for your child at home after hypospadias repair?
Caring for your child at home after hypospadias repair centers on keeping the penis and surgical area clean to prevent infection. [1]
Wash your hands with soap and water before touching the bandages.
Clean gently: if urine or stool gets on the bandages, clean with warm, soapy water and pat dry.
Change diapers more often — the stent drains urine constantly.
Sponge baths only: use warm water and soap, avoid rubbing the area, and pat dry.
No swimming and no playing in dirt, sand or mud until fully healed.
Limit activity: older children should avoid sports, bicycles and rough play for at least three weeks.
Does it hurt to pee after hypospadias surgery?
Peeing can hurt after the catheter is removed, but the pain usually eases within a few days and may take up to two weeks to go away. [1]
What are the risks and complications of hypospadias repair?
The risks of hypospadias repair include general surgical risks — anesthesia problems, infection, bleeding under the skin (hematoma), swelling, bruising and scarring — plus complications specific to this surgery. [1]
Complication | What it means |
Wound breakdown | The moved skin does not heal well in its new place |
Urethrocutaneous fistula | A small hole between the urethra and the skin that leaks urine; it can form months or years later |
Urethral stricture | Scarring narrows the urethra, weakening the urine stream and putting pressure on the bladder and kidneys |
Urethral diverticulum | A fluid-filled pouch that bulges from the urethra |
Shortening of the penis | More likely when surgery is done during or after puberty |
Recurrent curvature | The penis curves again after it was straightened |
Other possible problems include a weak or painful urine stream, pain in the testicles, sides or lower back, lumps or hard spots on the penis, discomfort during sex later in life, and urinary tract infections. [1] If narrowing develops, our guide to urethral stricture explains the treatment options.
Complication rates depend heavily on severity: distal repairs carry the lowest risk, while proximal and repeat repairs carry the highest. [2][3]
How successful is hypospadias repair?
Hypospadias repair has a high success rate; most repairs last a lifetime, and the penis works normally. [1] Children with severe hypospadias may need more than one operation, so regular follow-up visits matter. [1]
When should you call the doctor after hypospadias repair?
Call your child's healthcare provider right away if you notice any of these signs after hypospadias repair: [1]
Heavy bleeding
Fever of 100.4°F (38°C) or higher
Signs of infection
Increased pain or swelling
Vomiting three or more times a day
Trouble peeing
Urine leaking around the catheter
The catheter comes out
A diaper that is often dry
Keep every follow-up appointment so the care team can confirm healing and plan any further surgery. [1]
Conclusion
Hypospadias repair is a safe, common surgery that most children recover from in about six weeks. Mild cases usually need one operation, while severe cases may need two or more. The best results come from good preparation, careful wound care at home, and open communication with your child's surgeon about what the repair can — and cannot — achieve. [1]
Next step: Save or print the warning-signs checklist above and keep it on hand for the first two weeks after surgery. Then bring your questions to your child's next visit — and explore related guides, including undescended testicle in babies, in our Diseases & Conditions library.
FAQ
What is hypospadias repair?
Hypospadias repair is a surgery that moves the urethral opening to the tip of the penis. It may be done in one or two stages depending on how severe the hypospadias is.
At what age is hypospadias repair done?
Hypospadias repair is usually done between 6 months and 2 years after birth. Surgery during or after puberty can shorten the penis.
Is hypospadias repair a major surgery?
Hypospadias repair is a major surgery done under general anesthesia. Most cases are still outpatient, so children usually go home the same day.
How long does hypospadias surgery take?
Hypospadias surgery usually takes up to two to three hours. Two-stage repairs involve two separate operations about six months apart.
How long does it take to recover from hypospadias repair?
Recovery from hypospadias repair takes about six weeks for many children. Swelling and bruising usually fade after about two weeks.
How long does the catheter stay in after hypospadias surgery?
The catheter (stent) can stay in place for up to two weeks after hypospadias surgery. It helps the new urethra keep its shape and drains urine while it heals.
What is the most common complication of hypospadias repair?
A urethrocutaneous fistula — a small hole that leaks urine — is one of the most common complications of hypospadias repair. It can appear months or even years after surgery.
When should I call the doctor after hypospadias repair?
Call your child's doctor right away for heavy bleeding, a fever of 100.4°F (38°C) or higher, trouble peeing, or if the catheter comes out. Increased pain, swelling, repeated vomiting and an often-dry diaper also need prompt attention.
Should a baby with hypospadias be circumcised?
No. A baby with hypospadias should not be circumcised before repair, because the surgeon may need the foreskin to rebuild the urethra. Talk to a pediatric urologist first.
Does it hurt to pee after hypospadias surgery?
Peeing can sting after the catheter is removed. The pain usually eases within a few days, but it can take up to two weeks to go away.
Related Reading
Urethroplasty: Procedure, Recovery and Success Rate explains urethroplasty for urethral stricture.
References
Cleveland Clinic. Hypospadias Repair: Purpose, Procedure, Risks & Recovery. Cleveland Clinic. Last updated August 15, 2022. https://my.clevelandclinic.org/health/treatments/15991-hypospadias-repair
Pfistermuller KL, McArdle AJ, Cuckow PM. Meta-analysis of complication rates of the tubularized incised plate (TIP) repair. J Pediatr Urol. 2015;11(2):54-59. PMID 25819601. https://doi.org/10.1016/j.jpurol.2014.12.006
Cousin I, Basmaison C, Cousin E, et al. Complication rates of proximal hypospadias: meta-analyses of four surgical repairs. J Pediatr Urol. 2022;18(5):587-597. PMID 36058812. https://doi.org/10.1016/j.jpurol.2022.08.005
Do MT, Kim L, Im YJ, et al. Effect of Preoperative Androgen Stimulation on Penile Size and Postoperative Complication Rate in Patients with Hypospadias: A Systematic Review and Meta-Analysis. World J Mens Health. 2023;41(3):558-574. PMID 36649924. https://doi.org/10.5534/wjmh.220173
Further reading: U.S. National Library of Medicine. Hypospadias repair. MedlinePlus Medical Encyclopedia. Last updated July 1, 2025. https://medlineplus.gov/ency/article/003000.htm
Medical disclaimer
This article is for general education only and does not replace advice from your child's doctor. Always talk with a qualified healthcare provider about diagnosis, surgery and recovery decisions.
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