After hypospadias repair

This page from Great Ormond Street Hospital (GOSH) explains how to care for your son at home after he has had a hypospadias repair operation. If you have any questions, please contact the Urology Clinical Nurse Specialists or Panther Ward.

You should call the ward if:

• Your child is in a lot of pain and pain relief does not seem to help
• There is any oozing from the operation site
• The dressing falls off
• The amount of urine draining from the catheter is reduced or stops
• The catheter falls out

After the operation, there will be a flexible plastic tube (catheter) in the urethra with a large dressing covering the penis. Both the catheter and dressing need to be left in place for one week following the operation.

• Your child should not have a bath or shower until the catheter and dressing has been removed.
• If the dressing gets dirty during nappy changes, gently dab off any poo with a damp cloth.
• The catheter will drain into two nappies – one over the top of the other – to help keep the dressing dry. It also provides extra padding to the area while it heals. If your son is no longer in nappies, the catheter will drain into a bag.

• It is quite normal for your child to feel uncomfortable for a day or two after the operation. We recommend giving paracetamol every four to six hours according to the instructions on the bottle. You should not need to wake your child during the night to give a dose. 
• The catheter can irritate the inside of your child’s bladder, causing ‘bladder spasms’. These spasms feel like tummy pain or discomfort in the penis or bottom area. We will give you some medicine called oxybutynin to give your child. Constipation can make the spasms worse so make sure your child is eating a balanced diet and drinking plenty of fluids when you are back home.
• There is a small risk of infection following surgery so we will give your child a week’s course of antibiotic medicine to take.

• Your child should not sit astride or straddle toys such as bicycles for at least a week after the operation.
• He should remain away from nursery or school until the catheter and dressing have been removed.

• You will need to come back to GOSH one week after the operation so that we can remove the dressing and catheter. This will either be carried out on the ward or in theatre if your child needs a general anaesthetic.
• Having the dressing and catheter removed can be uncomfortable so we recommend you give your son the maximum dose of pain relief medicine according to the instructions on the bottle on the morning of the appointment. Do not, however, give a dose of bladder spasm medicine.
• When the dressing has been removed, your son’s penis will look red and swollen. This is normal and will settle down in a week. We will give you some ointment to put on to your son’s penis for the next few weeks. This is an antibiotic ointment and will reduce the risk of an infection developing. Please bring this with you to the appointment one week after discharge so we can show you how to apply it.

You should call the ward or your family doctor (GP) if:

• Your child is in a lot of pain and pain relief does not seem to help
• The operation site looks red, swollen and feels hotter than the surrounding skin
• There is any oozing from the operation site
• He develops a high temperature
• He is having trouble weeing

The doctor will see your child for a check-up appointment about three to six months after the operation – we will send you details in the post so please make sure we have your correct address.