Preoperative instructions for adults undergoing hypospadias repair surgery
Hypospadias is the most common urological birth defect occurring in upto 1/150 newborn boys, which measures upto almost 100,000 (1 Lakh) new cases every year. In todays’s era most of the times hypospadias is diagnosed immediately after birth. This was not true in the olden times. Hence, there are many adults living with hypospadias across the world either unrepaired or some who have failed hypospadias surgery in childhood. In India alone, there are an estimated 5 lakh adults who have either not received hypospadias surgery or have failed hypospadias surgery in their earlier years and their families or they themselves have given up.
Every year, we receive adults from all over India, many countries in Southeast Asia and rest of the world who travel to India to Hypospadias Foundation to find treatment for their Hypospadias problem. We have been able to successfully treat all the adults with hypospadias who have visited our centre. The pre surgery instructions for adults are different from a child undergoing hypospadias surgery.
Here is a detailed pre surgery instruction list for adult hypospadias:
- Empty stomach: The adult needs to be empty stomach for 6 hours on the day of surgery. If the surgery is in afternoon or evening, we usually advise a light breakfast in the morning following which they can consume water upto 2 hours before the surgery. This is a mandatory safety precaution to prevent vomiting and aspiration during anesthesia.
- Genital cleaning: We recommend using a betadine scrub (10% povidone iodine) to clean the genital area before surgery. This starts 48 hours before the surgery and has to be done till the morning of surgery. This reduces the risk of infection in the post-surgery period.
- No shaving: We generally do not recommend shaving the pubic hair because there can be bacterial colonization in the hair follicles which can in turn lead to infection. If the adult wants to shave the pubic hair, he can do it 3 days before the surgery date otherwise we trim the pubic hair in the OT before the surgery.
- Betadine gargle: More than 90% of the times oral mucosa graft is used in adults for hypospadias repair. We recommend oral betadine solution gargles starting the night before surgery.
- Admission: Admission is on the night before the planned hypospadias repair surgery. We secure an IV line on the previous night after admission and start IV antibiotics. This will ensure that there are good antibiotics in the system in the preoperative period which will decrease the risk of infection.
- Induction: General anesthesia is administered for all adults undergoing hypospadias correction. In addition, the anesthetist may also administer a regional block for better pain relief.
- Consent: Before hypospadias surgery is started, the adult undergoing the surgery has to fill up an anesthesia and a surgery consent form which is quite detailed in general. Please feel free to ask us about any doubts which you have. We always have the best of intentions and efforts to get you back home safely after hypospadias surgery.
We at Hypospadias Foundation are committed towards making the whole hypospadias treatment experience less stressful. It is not easy for an adult to undergo penile surgery. They have to be mentally prepared for the post-surgery dressing, post-surgical painful erections, longer recovery time and longer duration of per urethral catheter. We at hypospadias foundation want to make this journey towards cure more comfortable and be supportive to every adult undergoing hypospadias surgery.
Dr A.K.Singal is considered the best hypospadias surgeon in India and in the world. He is known for excellent results and devotion to managing children and adults with hypospadias and Disorders of sex development. He along with Dr Ashwitha Shenoy runs his urology and hypospadias clinics in Navi Mumbai and Mumbai area of western India. Dr Singal is an outspoken advocate of achieving the best results for hypospadias both clinically and psychosocially.