Hypospadias is a common congenital condition in boys where the urinary opening (urethral opening) is located on the underside of the penis instead of the tip. Hypospadias surgery is usually performed in early childhood, ideally before the age of five.

After successful hypospadias repair, the penis appears similar to a circumcised penis with urinary opening on tip and no curvature. The child will be able to pass urine in a single straight stream from the tip of the penis without pain or difficulty.

Because the surgery is performed very early in life, many children do not remember the condition or the procedure. As a result, many parents wonder:

Should we tell our child about his hypospadias surgery?

The answer is yes—open communication is important for your child’s long-term emotional and medical well-being.

Why parents have difficulty in talking to their son about hypospadias?

Many parents struggle with discussing hypospadias with their child due to social and emotional concerns such as

1. Cultural Taboo Around Genital Health

In many families, conversations about genitals or sexual health are considered uncomfortable or inappropriate. Parents who grew up in such environments may find it difficult to discuss these topics openly.

2. Fear of disclosure leading to social judgement and stigma

Parents often hesitate to disclose such conditions to their child due to fear that the child might share it with others, leading to social judgment. They may worry about teasing, stigma, or misunderstandings from peers, relatives, or the wider community. Concerns about how
the information could affect the child’s social relationships, self-esteem, and even future aspects like marriage or fertility can make parents cautious. As a result, some choose to delay or limit discussions, hoping to protect the child from potential negative reactions.

3. Concern About the Child’s Emotional Reaction

Some parents fear that their child may feel embarrassed, feel different from others, or become emotionally distressed if he learns about his hypospadias condition. Although these concerns are understandable, keeping the condition completely hidden may lead to problems later in life.

Why It Is Important to Tell Your Child About Hypospadias

1. Prevents Trust Issues

Children may eventually discover their medical history through records, online searches, or medical consultations. Learning about hypospadias surgery later in life from another source may make them feel betrayed or confused. Hence open communication is necessary to build trust and prevent unnecessary anxiety.

2. Reduces Body Image Concerns

As boys grow into adolescence, they naturally become more aware of their bodies. If they notice that their penis looks slightly different without understanding the reason, it may lead to unnecessary insecurity.

3. Prevents Anxiety During Puberty

Puberty brings many physical and emotional changes. Understanding their medical history helps adolescents feel confident and reduces anxiety about their bodies.

4. Helps With Healthy Relationships in Adulthood

Men who are unaware of their hypospadias repair history may feel worried or embarrassed about their appearance during intimate relationships. Knowing the truth early helps build confidence and reduces fear of judgment.

5. Seek help if they have medical issues

While with current hypospadias surgery techniques, the long-term results are very good, some of the children may develop issues in adulthood related to hypospadias or surgery done in childhood. These issues may include stricture, diverticulum, recurrent chordee or rarely urinary infections. Hence, it is important that the parents handover the medical records and tell their child about surgery so that they can seek proper help should anything happen.

6. Future urological interventions

Even in men without prior hypospadias, some of them develop kidney stones or prostate issues in late adulthood. At time of intervention, there is often cystoscopy done via urethra. Hence, it is important for them to know that they have a reconstructed urethra and share the same surgery record with their treating adult urologist.

What Is the Right Age to Talk About Hypospadias?

The best time to discuss about hypospadias with your child is during adolescence. At this stage, teenagers are mature enough to understand medical information and can process the explain logically.

Parents can explain that:
 He was born with a small difference in the position of the urinary opening.
 A hypospadias surgery was performed in childhood to correct it.

The condition has been successfully treated. It will not affect his normal life, urination, or future relationships. Having this conversation in a calm and supportive manner helps the child feel reassured and informed.

Why Medical Records of Hypospadias Surgery Are Important

When your child becomes an adult, it is important to provide him with all documents related to his hypospadias repair surgery. These records can help doctors if he ever needs medical evaluation later in life. Although most boys who undergo hypospadias surgery in childhood live completely normal lives, some rare complications can occur in adulthood, including:

1. Urethral Stricture: The reconstructed urethra may become narrow over time, affecting urine flow.
2. Urethral Diverticulum: The reconstructed urethra may become slightly dilated or relaxed.
3. Residual Chordee: A mild curvature of the penis that was not fully corrected in childhood may become more noticeable in adulthood.

Having the surgical history and medical records helps doctors provide appropriate treatment if any issue arises.

Who Should Explain about Hypospadias to the Child?

The best approach is for parents to have the conversation along with the hypospadias surgeon.

Together, they can reassure the child that:
 The condition was corrected successfully.
 He can lead a completely normal life.
 If he has questions or concerns, he can discuss them privately with the doctor.

We also recommend a follow-up consultation around 18 years of age so that the young adult fully understands his medical history and can address any concerns.

Final Thoughts

Talking to your child about hypospadias and hypospadias surgery may feel uncomfortable at first, but open and honest communication is important. When parents discuss the condition At the right age, it helps build trust, confidence, and a healthy body image. Providing accurate information ensures that your child grows into adulthood feeling reassured, informed, and comfortable with his medical history.

About hypospadias foundation

Hypospadias Foundation, located at MITR Hospital in Kharghar, Navi Mumbai in the state of Maharashtra, India is a centre specialized for the treatment of children and adults with hypospadias. Our expertise in hypospadias makes us one of the best centres for hypospadias repair in the world. We treat children from more than 30 countries in the world and from all over India. Our dedication in this field has helped us achieve excellent outcomes.

Dr A K Singal is an expert and top hypospadias surgeon in India. He is a gifted surgeon and his expertise in this area has helped us achieve excellent outcomes in primary and failed hypospadias in children as well as adults. Dr Ashwitha Shenoy is an expert hypospadias surgeon with a special interest in hypospadias and pediatric urology. Both Dr Singal and Dr Shenoy work together to give best results for hypospadias surgery in India for both children and adults.

Hypospadias is a birth defect which affects a vital organ of the body- Penis. Penis is the most important organ for urinary and sexual function in a male. Though everyone worries more about sexual function, let me tell you as an expert hypospadias surgeon and a pediatric urologist that both urinary and sexual functions are equally important. While we may need penis for sexual function may be once or twice a day and for maybe for 30-40 years in our lives, we certainly need it for urinary function right from birth till we die and many more times each day. Hence the purpose of hypospadias repair is to set both the functions right in one go- single stage urethroplasty. This includes correction of the curvature of the penis (chordee correction) as well as making a good caliber smooth new urethra till the tip of penis.

But all said and done – Hypospadias treatment means a surgery. Surgery word itself is very scary and it requires a lot of courage and faith for the parents to handover their little one to a surgeon and let me tell you it is not easy for parents to hand over their young kid for a surgery. Lot of things go around in their minds about risks, results and safety of both surgery and anesthesia. Having been a pediatric urologist for almost a decade now, I can feel their helplessness and pain. I never let these feelings overpower me and become a stumbling block to delivering good care. I try to channelize them in the right way and empathize with the family and tell them upfront that I know how they are feeling. And then I tell them what all safety precautions and risk mitigation strategies we have lined up for the hypospadias surgery. My favorite sentence at this juncture is “Safety first everything else later”.

An helmet/ bike analogy works well in this situation: we should always follow all precautions before we go for a bike ride and most importantly wearing a helmet. We may wear a helmet a thousand times and not have an accident but the day we don’t wear it that is the day when we are vulnerable and if something happens- it will be life threatening. Similarly, while doing a hypospadias surgery on a small kid we also take all precautions to make sure that we are absolutely prepared even if something happens in that rare 1/1000 chances.

Hypospadias Surgery Checklist:

1. Pre-operative fitness tests: A thorough history is taken for any evidence of infection, other illness and any familial disorders. A complete blood count and a urine test is done to check for body parameters. A pediatrician consult is often taken for a systemic examination. Chest xray is no longer recommended routinely before elective surgery if the chest examination is normal.
2. Pediatric Anesthesiologist: An anesthesia doctor adept at handling kids and regularly giving anesthesia to small kids is the second most important team member after the pediatric urologist.
3. Hypospadias surgery set: Hypospadias repair surgery require fine, sharp and specialized microsurgery instruments- we keep is separately as a “Hypospadias Set” which is not used for any other surgery.
4. Operation theatre: OT needs to be clean, sterilized, have all safety equipment for anesthesia, good lighting and all possible infection control measures.
5. Antibiotic dose just before surgery: We give a dose of injectable broad spectrum antibiotic just before starting the surgery as an infection prevention measure.
6. Trained staff: Well-trained nursing and junior doctor staff is needed both while assisting surgeries as well as post-operative management, since at Hypospadias foundation at MITR Hospital, Navi Mumbai, India- we do more than 150 hypospadias repairs every year- even the ward assistants know the care of these babies after surgery.
7. Standardised protocol of surgery:  This has been covered in another blog- read it here.

As a Pediatric Urologist and Hypospadias Specialist, I feel overwhelmed when parents trust me and handover their little ones under my care. It is a big responsibility and I try my best to handle them with care. Trust and faith that everything will be fine goes a long way in finding a cure for hypospadias. After all we are all instruments of god trying to do our best. As long as the intentions and efforts are honest, the results will also be good.

About Dr A.K.Singal: Dr Singal is a renowned and top pediatric urologist & one of the best hypospadias surgeons in India. He is well known for single stage hypospadias surgical corrections. He operates children with hypospadias at his centre @ Hypospadias Foundation at Kharghar Navi Mumbai, at MGM & Fortis Hospitals in Vashi, at Fortis Hospital in Mulund, Mumbai and at Jupiter Hospital in Thane.

Dr A.K.Singal during Hypospadias surgery

Please feel free to write to us for an opinion at hypospadiasfoundationindia@gmail.com or fill this contact form http://hypospadiasfoundation.com/contact-patient.htm

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