Hypospadias Repair

Hypospadias is a birth difference in which the opening of the urethra lies on the underside of the penis instead of at the tip, often with a hooded foreskin and a downward bend (chordee). Repair moves the opening to the tip, straightens the penis and rebuilds a normal looking glans.

Surgery allows a straight urinary stream while standing and normal sexual function later. Mild forms have high success with one operation; severe forms near the scrotum often need staged surgery and have a notable rate of further procedures.

What Hypospadias Repair involves

The surgeon first degloves the penile skin and checks straightness with an artificial erection test; any bend is corrected by releasing tethering tissue or placing stitches on the upper side. For most distal cases the tubularised incised plate (TIP or Snodgrass) method is used: the strip of urethral plate is cut along its midline to widen it and rolled into a tube over a fine catheter, covered with a second layer of tissue from the foreskin or dartos to prevent leaks, and the glans wings are closed over it. For severe cases, stage one lays a graft from the inner foreskin or the lining of the cheek on the underside of the penis; 6 months later stage two rolls it into a tube. The foreskin is either used for the repair and removed, or reconstructed. A soft stent drains urine into the nappy for about a week.

Who is a good candidate for Hypospadias Repair?

Repair is usually done in infancy, but older boys and adults with untreated or failed repairs can also be treated.

• Boys aged about 6 to 18 months, the preferred window
• Opening far enough from the tip to affect the stream, or any significant bend
• Adults with symptoms from an unrepaired hypospadias
• Failed previous repairs with fistula or narrowing, in experienced hands

It is usually not the right choice if:

• Babies who have been circumcised beforehand lose useful tissue, so do not circumcise before assessment
• Very mild glanular forms with a straight penis and good stream may need nothing
• Severe forms with undescended testes need hormonal and genetic evaluation first
• Active nappy rash or infection on the day of surgery

Technique options

• TIP (Snodgrass) urethroplasty: Most distal and mid-shaft cases in one stage.
• Meatal advancement (MAGPI): Very distal openings with a mobile meatus.
• Onlay or tubularised preputial flap: When the urethral plate is too narrow.
• Two-stage graft repair: Proximal hypospadias or severe chordee; buccal mucosa graft if the foreskin is gone.

What happens during your treatment

Surgery takes 1 to 3 hours under general anaesthesia with a caudal or penile nerve block, so the child wakes comfortable. It is often a day case or one night. The penis is wrapped in a dressing and a small tube drips urine into a double nappy. Bladder spasms can cause brief crying episodes and are treated with medicine.

Preparing for your trip

Plan for 10 to 14 days in Istanbul. Your surgeon reviews photographs and your medical history before you book, and you meet in person the day before surgery for examination, marking and consent with a professional interpreter.

• Stop smoking and nicotine at least four weeks before and after surgery; it is the single biggest avoidable cause of wound problems
• Tell the team about every medicine and supplement you take; blood thinners, some herbal products and hormone treatment may need to be paused on your doctor's advice
• Arrange for someone to travel with you or to be reachable, and keep the first days at home free of work and lifting
• Book a changeable return flight; your surgeon confirms when you are fit to fly

Recovery and results

The dressing and stent come off after 5 to 10 days. Swelling and bruising look alarming at first and settle over 2 to 6 weeks. No straddle toys or swimming for about 3 weeks. Checks are needed at around 3 and 12 months, again after toilet training and ideally after puberty, because some problems appear with growth. This long follow-up needs a paediatric urologist at home.

• Back to everyday activity: 2 to 3 weeks
• When results show: Appearance settles over 2 to 6 months
• How long they last: Permanent; follow-up to adolescence

Safety, risks and revision policy

Complications relate mostly to healing of the new urethra, and rise with the severity of the hypospadias.

• Urethrocutaneous fistula, a small leak on the underside, the most common problem, repaired after 6 months
• Narrowing of the new opening or urethra with a thin or spraying stream
• Breakdown of the glans repair
• Recurrent bend of the penis
• Urethral diverticulum or hair in the urethra with some flap methods
• Overall re-operation in roughly 5 to 10 percent of distal and 30 percent or more of proximal repairs

Every written proposal arranged through Clinic-Y states what the clinic covers if a correction is needed. Ask for it before you book, not after.

Cost of Hypospadias Repair in Türkiye

Clinic-Y does not publish a single price for Hypospadias Repair, because the honest figure depends on your case. What moves it:

• Severity and whether one or two stages are needed
• Use of a buccal mucosa graft
• Paediatric anaesthesia and nursing
• Length of stay and dressing visits
• Primary versus redo surgery

Send your photographs or reports and you receive written, all-inclusive proposals from suitable teams, side by side. Reviewing your case is free.

Frequently Asked Questions