Hypospadias can have a significant impact on a person’s life, especially as they transition into adulthood. While the physical challenges may be addressed through surgical procedures or other treatments, there are also emotional and psychological aspects to consider. Undergoing hypospadias repair in adulthood is not easy.
Recovery for an adult after hypospadias surgery can take several weeks or even months. The length of recovery will depend on the type of surgery performed and the individual patient’s healing process. Here are few instructions for adults undergoing hypospadias surgery.
- Diet: Oral feeds can be started for 3-4 hours after surgery. We advise high protein diet in the post operative period which includes eggs, meat for non-vegetarians and paneer, tofu, dal, pulses etc for vegetarians. Healthy food promotes good healing. Adequate water intake and high fibre diet in the post operative period is a must to avoid constipation.
- Catheter care: After any hypospadias repair, there will be a urinary pipe called urethral catheter which is left across the hypospadias repair site. This goes into the bladder and drains urine continuously. The catheter is tied to penis with a small stitch, and it is generally removed after 14 days in primary or staged repair and after 21 days in single stage repair. The urinary catheter is connected to the urine bag which must be emptied every 3-4 hours. After urethroplasty in adults along with per urethral catheter there is also a suprapubic catheter. In the presence of suprapubic and urethral catheter, we keep the urine drainage open only from the suprapubic catheter and per urethral catheter is kept closed.
- Hypospadias Dressing care: At the end of hypospadias surgery, we place a soft gauze roll dressing on penis to give some support to the healing penis. There may be minor bleeding from the operated site for first 3-4 days which is nothing to worry about. We typically change the dressing on day 4 to check the healing and look for signs of infection. Operated site inspection is done once every 4 days and re-dressing is done till catheter removal.
- Keeping operative area clean & betadine washes: We advise local washes with saline & betadine – 3 to 4 times a day coupled with local antibiotic ointment application to prevent infections.
- Discharge after hypospadias surgery: An adult after hypospadias repair will stay in the hospital for 2-3 nights after surgery for antibiotic injections and for pain relief. IV antibiotics are given for 48 hours after surgery.
- Pain relief: We prescribe an oral analgesic medicine till catheter removal. This should be taken after food and not on empty stomach. We also give a medicine called oxybutynin which is an anticholinergic and prevents bladder spasms (painful bladder contractions due to catheter). In addition to these, adults can get severe pain due to penile erection at night. Hence, we prescribe a benzodiazepine medicine to decrease the intensity of penile erection.
- Medications: A broad-spectrum antibiotic such as cephalexin or bactrim is also prescribed to prevent infections along with an antacid medicine such as pantoprazole.
- Walking is allowed after surgery; we encourage ambulation as early as post operative day 1 after surgery.
- Visits with doctor: We like to see the patients on day 4 after surgery for dressing change and every 4th day thereafter.
- Bathing: Bathing can be started only after dressing and catheter removal. Till then sponge bath is recommended.
- HBOT (Hyperbaric oxygen therapy): We recommend hyperbaric oxygen therapy for adults undergoing hypospadias repair. This is started 48 hours after surgery and 5-7 sessions are recommend depending on the type of surgery. It’s a 1-hour daily session and is taken from day 3- day 7 post surgery.
- Oral care after graft: If oral mucosa graft is harvested, we advise a non-spicy soft diet for initial 2 days post-surgery . Food should be at room temperature or little warm and not very hot. A local anaesthetic gel is applied at the graft harvest site in the oral cavity every 6 hours which provides good pain relief.
- Ointments on penis: We advise putting a broad-spectrum antibiotic ointment such as Neosporin or mupirocin locally on the penis after dressing removal.
After hypospadias surgery, it’s important to follow your doctor’s instructions carefully to ensure proper healing and minimize complications. Please feel free to get in touch with us if you need any further information. We hope and pray that you recover well and without any complications from hypospadias surgery.
Hypospadias foundation is the best and leading centre in the world for hypospadias treatment of children and adults. At Hypospadias foundation, Dr A.K.Singal and Dr Ashwitha Shenoy, expert hypospadias surgeons, rated as best hypospadias surgeons in India personally supervise care for hundreds of children and adults every year. Hypospadias surgery in adults can be a complex procedure, but it can significantly improve quality of life for those affected by this condition.