Hypospadias is a congenital condition in which the urinary opening (meatus) is located on the underside of the penis instead of at the tip. Hypospadias repair surgery is a well-established and successful procedure that can be performed in infants, children, adolescents, and adults. However, choosing the best age for hypospadias repair plays an important role in healing, recovery, and long-term outcomes.

What Is the Best Age for Hypospadias Surgery?

Most expert hypospadias surgeons recommend performing surgery between 6 and 18 months of age. Surgery before 3 years of age is considered ideal, and if someone misses this period, surgery before 8 years of age is still strongly recommended if early repair was not possible.

Hypospadias Surgery in Infants (6–18 Months)

The ideal age for hypospadias surgery is between 6 and 18 months. At this age:

• Penile tissues are soft, elastic, and heal faster
• Scarring is minimal due to high tissue regeneration
• Infants are unaware of their genitalia and body image
• There is no psychological impact or memory of surgery

Early hypospadias repair also allows normal toilet training and smooth bladder control development. Post-operative care is easier in infants, as diaper changes simplify wound care and recovery is less stressful for parents.

Older children:

• Are more aware of their genitalia and may feel shy or anxious
• Experience more fear and perceived pain after surgery
• May find dressing changes difficult
• Sometimes hold urine after catheter removal due to fear of pain

Despite these challenges, healing and success rates remain high when surgery is performed by an experienced hypospadias surgeon.

Hypospadias Surgery in Teenagers

Teenage boys with untreated or failed hypospadias often feel embarrassed and reluctant to undergo surgery. In cases of hypospadias with chordee (penile curvature), we recommend delaying surgery until penile growth is complete. Avoiding surgery during active growth may prevent interference with natural penile development

Hypospadias Surgery in Adults

Hypospadias repair in adults is possible and can be highly successful. However, recovery is slower compared to children because:

• Adult penile skin is thicker and less elastic
• Healing takes longer
• Pubic hair can affect wound care
• Night-time erections may stress sutures and increase complication risk
• Infection issues are higher
• Urethral and extra safety supra-pubic catheter are also needed.

Even in adulthood, good outcomes are achievable in expert hands. Adult hypospadias surgery success rates at Hypospadias Foundation India are over 95%, which are best in the world.

Is There an Age Limit for Hypospadias Surgery?

There is no upper age limit for hypospadias surgery. The success of repair depends more on the experience of the hypospadias surgeon than the age of the patient. With proper evaluation and surgical expertise, excellent results can be achieved even in adulthood.

Importance of Choosing an Expert Hypospadias Surgeon

Before planning hypospadias surgery, it is essential to consult a specialist hypospadias surgeon. An experienced surgeon will:

• Carefully examine the child or adult
• Assess severity, chordee, and previous surgeries
• Recommend the best timing and surgical technique

At Hypospadias Foundation, children and adults from over 30 countries undergo hypospadias repair. The oldest successfully treated patient was a 50-year-old man with failed hypospadias repair and urethral stricture, operated without complications. This highlights the importance of choosing a specialized center for hypospadias treatment.

Dr A K Singal is a highly experienced and internationally renowned hypospadias surgeon in India, widely regarded as one of the leading experts in hypospadias repair for both children and adults. He has dedicated his professional life to the treatment of complex and failed hypospadias cases, helping patients achieve excellent functional and cosmetic outcomes.

With decades of focused experience in primary and redo hypospadias surgery, Dr Singal’s expertise has contributed to consistently high success rates in infants, older children, adolescents, and adults with hypospadias.

Dr Ashwitha Shenoy is an expert pediatric surgeon with a special interest in pediatric urology and hypospadias surgery. Her training and experience in managing hypospadias in children ensure meticulous surgical care, age-appropriate planning, and excellent long-term outcomes.

Together, Dr A K Singal and Dr Ashwitha Shenoy work as a dedicated team to provide comprehensive hypospadias treatment in India. Their combined expertise allows them to manage simple to complex hypospadias cases, including failed repairs and adult hypospadias, delivering some of the best outcomes for hypospadias surgery in India.

Contact us:

For appointment kindly contact us at the contact details given below.

MITR hospital & Hypospadias Foundation, Kharghar, Navi Mumbai, India – Tue/Saturday 4:00pm-6:00pm, Call for appointments: +91-6262840940. Or email us at hypospadiasfoundationindia@gmail.com

Watch Video of Distal Penile Hypospadias Surgery by Dr A.K.Singal, Best Hypospadias Surgeon In India.

We are privileged to care for children from across the world who come with their parents to our Hypospadias centre in Navi Mumbai, India looking for the best in Hypospadias surgery and treatment. The love and affection which we give to the kids is a mirror image of the trust and faith which family puts in us. It is the simple rule of medical care and cure.

Happy kids= happy parents = good results= happy surgeon who sleeps well. Our nurses and junior doctors almost adopt the kid as one of theirs and then play with the kid during recovery time and we see that with such a personalized care the kids recover after hypospadias surgery in no time.

Somebody said it aptly, “When you are happy the time flies very fast”. Hence, if everyone remains happy and in high spirits after a hypospadias surgery, time just disappears. Long journey to India and time spent here seems worthwhile.

The Email from Dhaka, Bangladesh:

Dear Sir,

Here is our testimony. As you know we are from Dhaka city in Bangladesh and when our son, baby Satyaki Sarkar, was born, he had a problem which the doctors named distal penile hypospadias. So when doctor told us about this problem we were very worried. We didn’t know what to do because we never heard the name of such type of problem. I searched in internet about the problem for best doctor for hypospadias. After searching internet we got the address of Dr. Arbinder Singal, Hypospadias specialist surgeon and Hypospadias Foundation in Navi Mumbai, India. We also watched the video of hypospadias repair surgery which they had uploaded related to surgery about hypospadias of a baby. We also studied the articles of Dr. Singal and others hypospadias surgeons around the world. After that we finally decided to do the hypospadias repair surgery in Navi Mumbai India, at MITR Hospital & Hypospadias foundation. We contacted with the authority of Hypospadias foundation for getting appointment. Ms. Emily Paul and Dr. Rajkumar Gupta arranged appointment for us in a cordial way.

Now it was time for hypospadias surgery. We met with Dr. Singal on 21st March. He appointed us on 23rd March for operation. We were so tensed about Satyaki’s operation. But Dr. Singal and his team were so cooperative that we forgot about all tensions and focused only on Satyaki’s operation. At last, on 23rd March, 2015, the hypospadias operation was done successfully without any problem. After having surgery we stayed in the hospital for one day and the next day they discharged us. After having surgery we felt that we came in the right place because my baby had no surgical pains. He recovered so quickly that we couldn’t imagine. We realized that best results are possible after hypospadias surgery.
We would like to specially mention about the nurses and staffs of hypospadias foundation. They were so cooperative, and cordial. They can manage the babies with hypospadias after surgery in a very caring and professional way.
Now my little boy is completely recovered and doing well without any problem. You may post the picture of my baby and us which you have to us. Because we think that this may help to realize the families that hypospadias problem may be solved through proper surgery. We also think that through our message and picture many families who are suffering from this problem will get new aspirations and hope.
At last we again want to give thanks to Dr. Singal and his team for doing this surgery in an excellent way. We wish success of this foundation in every step of its life.
With best regards

Sanjeev Kumar Sarkar
Father of Satyaki Sarkar
Dhaka, Bangladesh.

Chordee means that the penis is bent (curved penis). Penis mostly gets bent downwards hence it is called ventral chordee and is seen commonly seen in children with hypospadias. In children with other type of anomaly which is much rarer than hypospadias called epispadias the penis may be bent upwards, it is called dorsal chordee. Hypospadias is atleast 20-30 times more common than epispadias, hence when someone uses the word chordee it is by fault supposed to mean ventral chordee as seen in hypospadias.

Why does chordee happen?

When the penis is getting formed between 8-12 weeks of pregnancy, the urethra (urinary passage) also starts getting formed from the base of penis to the tip of penis. This happens gradually under the 3influence of male hormones produced by the testis. All around urethra, a special tissue called corpus spongiosum is also formed through which the urethra runs. The two cylinders of tissue called corpus cavernosa are also formed. Together equal sizes of spongiosum and two cavernosa cylinder are responsible for a straight penis. When the urethra is short as in hypospadias, the spongiosum tissue is a3lso short, the skin and dartos tissue under skin is also short and sometimes the corpora can also be curved. Hence chordee results from this shortage of these tissues on underside of penis.

Do all hypospadias have chordee?

Chordee is seen more than 50% of all hypospadias but this also depends on the severity of hypospadias. Generally, the more severe the hypospadias is, higher the chances of chordee. Hence, chordee is more common in scrotal hypospadias than distal penile hypospadias. This is a generalization and it is not true in all cases as we have seen lot of cases of chordee without hypospadias and also minor hypospadias having a major degree of chordee.

How is chordee checked and graded?

Chordee can sometimes be seen by the parents when the child has an early morning erection which happens even in small babies. Generally we tell the parents to click the picture from the side to document the chordee degree. Chordee must always be checked during hypospadias surgery by doing an artificial erection test. This is infact a mandatory test for all hypospadias and the most important thing to be taken care of during hypospadias surgery. If chordee is not checked and left untreated, it can create lot of issues in adulthood and need surgery again which is much more difficult in adulthood. Chordee is graded in degrees like 30 degrees, 45 degrees or 90 degrees or also as mild, moderate or severe.

Does chordee always need surgery repair?

A straight penis is important to have straight stream of urine as well as for having normal sexual intercourse. Hence, if the penis has anything more than 15-20 degrees of bend should be corrected.

How is chordee repair surgery done?

• Degloving of penis: In any hypospadias surgery or chordee repair surgery, the first step is called degloving of penis. Degloving means that the penis skin is taken down till the base of penis by a circular incision around head of penis while saving the opening of hypospadias and urethral plate. Generally, there are some abnormal tissues around base of penis which cause chordee and once these are divided chordee gets corrected in most cases. Then a tourniquet is applied on the base of penis and saline solution is injected into the head of penis or corporal bodies. This is called artificial erection test and allows the hypospadias surgeon to assess the degree of chordee.
• Tunica albuginea plication: If there is still chordee then further steps need to be done to correct chordee. If the chordee is mild, then we perform tighten the top side of penis with a non-absorbable stitch to straighten the penis.
• Division of urethral plate: If the chordee is still severe then a cut needs to be given to divide the urethral plate between hypospadias opening and the head of penis.
• Dermal graft for chordee correction: Chordee is again checked and if it still severe then corpora needs to be lengthened by placing a dermal graft on underside of penis. In case a dermal graft is placed, then a single staged repair can’t be done and a staged hypospadias repair is done.

It is important for a hypospadias surgeon to make sure that the chordee is completely corrected during hypospadias surgery. It requires experience to do a stepwise assessment of the chordee in every individual case and then proceed with chordee repair as detailed above. The importance of having a straight penis cannot be overemphasized.

About the author:

Hello Dr A.K.Singal,

My feedback from my baby’s operation at Hypospadias Foundation & MITR hospital in Navi Mumbai, Kharghar, sector 21:

When I was told by  my baby’s doctor at the time of birth that he had hypospadias, we were very worried about it as it was the first time I had heard such case. Then I started searching about treatment and could not find any specialist locally in Afghanistan. Then we searched for a hypospadias specialist in India and could find the best pediatric urologist surgeon in Mumbai called Dr. A. K Singal in MITR hospital in Navi Mumbai although, I searched in Delhi and other states. Indeed what all I found it was just from Google net and I was really not sure what is going to be happen. Many questions arose into my mind that how the operation is going to be done? How many days my son would be admitted? And many other questions were there.

Eventually, I got appointment with the MITR hospital via email with Mrs. Emily Paul who was very helpful and then we decided to go India for the treatment and finally reached the mentioned hospital on the 1^st December, 2014. In the same day, Dr. A. K Singal visited my child and he impressed me when he talked about the operation and we decided to operate him after two days. Then on the 3^rd December my baby’s operation was done.
The operation was done in a very professional way and successfully with no issue. Then I realized that I took a really right decision and found the right hypospadias doctor. It was amazing that in the same day my baby did not have any pain and discharged from the hospital but I requested to remain for some more days for betterment of the child. 

We (me and my wife) have very good memories from the Hypospadias Foundation and MITR Hospital especially from Dr A.K.Singal and now we know why he is a renowned Pediatric urologist and one of the best Hypospadias surgeons in India. The staff of Hypospadias Foundation based in MITR Hospital is good and the nurses were really outstanding. I thank them too.

My little angel is doing very well after surgery with no issue and we overcome those all tensions and worries which we had in the past. I really appreciate Dr. A. K Singal and whole MITR team with professional communication and cooperation and your friendly environment.

Considering that our son had hypospadias which can have lot of stigma, we request you to keep his name and identity confidential. We would be happy to interact with parents whose children are suffering from hypospadias any time offline.

Thank you Dr. Singal.

Best Regards,

Mr M.H., Herat, Afghanistan

Case description:

Master F.H.,8 months old child underwent distal penile Hypospadias treatment at our hospital recently (Dec 2014). Father had written to us about a month back expressing a desire to travel for Afghanistan to India for the hypospadias repair surgery. They had sent us pictures of the penis via email and we could explain to them the type of anomaly and the surgery needed for the same. Fortunately, the father took very good and clear pictures as instructed and it was easy for us to understand even without examining the child. Ms Emily Paul and Dr Rajkumar coordinated the OPD appointments and then one fine day the baby was at our hospital in Navi Mumbai. We confirmed the hypospadias to be distal penile hypospadias and did the pre surgery checkup and fitness by a Pediatrician. We took up the baby for surgery on 03/12/2014 and surgery was done using Tubularised Incised plate urethroplasty (TIP repair) also called Snodgrass repair or Snodgrass urethroplasty. Originally described by Dr Warren Snodgrass, the TIP repair is one of the most reliable and common repairs done worldwide for distal and midpenile hypospadias in selected and suitable cases.

The surgery was finished in one hour and F.H. was allowed feeds after 3 hours of surgery. He was at his playful best by evening and we planned to discharge the baby. Parents were very worried about taking him to a hotel and requested to stay in the hospital for another week till the dressing and the catheter were taken out. In normal circumstances, we discharge most of the hypospadias surgery kids by evening of surgery but here understanding the situation we allowed them to stay for a week. Finally the catheter and the dressing were removed in 5 days and the parents took the child to Pune with them. I saw them on 15^th Dec 2014 once again before their final flight back home to Afghanistan from Delhi. He was doing very well and the penis had healed very nice with good cosmetic and functional outcome.

Staff and nurses were very fond of master F.H. as he was a very happy baby and used to come to everyone’s arms easily and used to play with them. He used to be in my lap all the time. All of us here at MITR Hospital and Hypospadias Foundation wish him the very best in life. And we all miss him.

About the Hypospadias Foundation & Dr A.K.Singal

Hypospadias Foundation in Navi Mumbai, India is the world’s only organisation committed and dedicated to treatment and care of children having hypospadias. Over last 6 years children from all over India and from more than 15 countries have benefitted from care at Hypospadias Foundation.

Dr A.K.Singal, Pediatric Urologist and Hypospadias Surgeon is an expert and renowned surgeon for management of children and adults with Hypospadias. Dr Singal and Dr Manish Dubey are close friends and together started Hypospadias Foundation in Nov 2008.

Dr Singal can be contacted by filling up this form: Enquiry form for Hypospadias

Or you can call up Dr Rajkumar (Dr Singal’s assistant) at +919821261448

His clinic timings in Navi Mumbai, Thane and Mumbai are available here:

Clinics and Timings for Dr Singal

Hypospadias repair surgery videos by Dr A.K.Singal: