Before reading this section, please refer to General instructions after surgery in this section of the website.

Your child has just undergone repair of hypospadias, which entails recreating the end of the urethra, or the tube through which he urinates, as well as the head of the penis. He may have a tube in his penis, which is flush with the tip and sewn in with blue or black suture material. The tube ensures good bladder drainage and prevents urine from being expelled through the site of repair. If your child does have a tube, you should see a steady drip of urine from the tube. If not, or if the child is observed to void normally around the tube, the tube may be plugged. If this is the case, please let us know so that we can remove it. Occasionally, the tube causes bladder spasms. These are episodes when your child may suddenly scream, appear uncomfortable, or grab at his penis. If you believe this is happening, please let us know so that we can prescribe medication to help control the spasms. The bladder tube will stay in for a period of time determined on the day of surgery, typically less than 2 weeks. You will also notice that his penis is wrapped with a clear dressing called Tegaderm which looks like Saran Wrap. This is to control post-operative swelling.

For the initial few days, there is not much you need to do with your child other than frequently change his diaper, about every 3-4 hours. If he gets any poop on his penis, go ahead and dunk him in the bathtub and gently wash it off. The plastic dressing may fall off on its own. If it does, begin applying Vaseline or Aquaphor (preferred) to the entire penis. Be careful not to get any ointment inside the tube as it may clog it. If the dressing has not fallen off by 72 hours after surgery, go ahead and soak him in the bathtub and gently tease the plastic dressing off. Be very gentle. Do not pull on the dressing such that it stretches the penile skin. If you're having trouble with it, please give us a call. Once the dressing is off, you may bathe the child daily and keep his penis coated with ointment every time you change his diaper.

If your child has a tube, he will be kept on oral antibiotics. This can sometimes lead to diarrhea, so keep an eye on his diaper and make sure he doesn't get poop on his penis. He will also be given a prescription for codeine if he is old enough to tolerate narcotic. At the end of the operation, we place numbing medicine either in the tailbone (caudal) or at the base of the penis (penile block) to provide post-operative pain relief. This usually wears off in 4-8 hours. Please fill your prescriptions for pain medicine immediately upon leaving the hospital. By doing so, you will have medicine available when your child starts to become uncomfortable. You may also need to begin giving him antibiotics no later than 8 hours after surgery.

If you notice any problems with the tube, call us. You may notice some mild oozing, and this is normal. Any heavy bleeding should be reported to us immediately. If you child runs a fever, or if there is any redness or pus at the surgery site, we should also be informed immediately. A thick, adherent, yellowish film frequently forms on the head of the penis. This film, called exudate, is a normal part of healing and should not be confused with pus, which is runny. You should expect a considerable amount of bruising and swelling, which is normal. If you feel that your child is having an unusual amount of pain or seems unable to urinate, please let us know immediately. Generally, infants will act normally within 24 hours. If things do not seem quite right, do not contact your local pediatrician or your local emergency room. Instead, call us first, as we may be able to advise you as to the best course of action. Frequently, your child is experiencing a normal post-operative course and he will go on to heal quite well.

A follow-up appointment will be scheduled by the surgical facility. If your child has a drip tube sewn to the head of the penis, an appointment to remove this tube will be scheduled shortly after surgery, usually within 2 weeks.