Circumcision in hypospadias repair?

Sometimes I want to blog but I don’t know what to write. I get stuck as we all do with life, kids, the business, busyness. Which is kind of odd, given the volumes of hours I’ve spent researching hypospadias and since it was colossal for us for so long. But I talk to a lot of moms. So I’ll share a recent conversation (removing specifics and generalizing the situation). I’ve recently spoke with a mom who believed her son had mild hypospadias and was preparing to consult with a urologist about whether or not surgery would be recommended. The urologist diagnosed the hypospadias as second degree. This is where the urethra opens along the shaft versus more distally at the head of the penis. The surgeon recommended surgery due to the chordee and the severity. The surgeon also recommended circumcising during the repair and keeping the child in the hospital for a week while the catheter was in place. The concerns for this mom were complications, the decision itself and functionality later in life.

So first regarding circumcision in hypospadias repair, is there value to keeping the foreskin intact until the surgery/ies are complete? Some surgeons prefer waiting 6 months after hypospadias repair to reconstruct the foreskin, or to circumcise, to ensure everything has healed without complication before operating on the foreskin. About the hospital time, we didn’t stay overnight with our son following the urethroplasty – we did stay in state and close to our surgeon for a few days – however, we did stay overnight following the buccal mucosa graft in stage 1. I’ve heard some surgeons recommend week-long hospital stays. While this depends on preference, grade and procedure performed, most hypospadias surgeries are performed as outpatient. If you’ll be leaving the hospital the day of surgery and you live far away, you may want to stay close for the first few days.

Hypospadias surgery does carry higher risks of complications. I believe for this reason you want to select your child’s surgeon wisely and ensure the timing is right for their procedure. Personally, I feel their bodies should be optimum for healing which includes being as anti-inflammatory as possible.

As moms we can be hard on ourselves. Make the decision regarding your child’s hypospadias repair to the best of your ability after giving yourself time to learn and meet with surgeons, give them the best chance for success in that decision and stick behind it once you make it. Good luck. You will make it through.

– Christina

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