Pre-operative Instructions:
- Pre-operative Tests:
Your doctor will order necessary blood and other investigations before hypospadias surgery to ensure your child is fit for the procedure. Typical tests include CBC (complete blood count), Urine routine, tests for HIV, Hepatitis B & C exposure.
- Medical Conditions:
Notify the doctor if your child has any cold, cough, fever, diarrhoea or known allergies or any other medical or surgical conditions requiring treatment before the hypospadias repair.
- Fasting Requirements:
Your child needs to be fasting prior to hypospadias surgery to ensure a hassle-free smooth conduction of anaesthesia.
Fasting guidelines to be followed are as follows:
a.Ensure your child does not eat any solid food for at least 6 hours before surgery.
b.Stop giving mother’s milk 4 hours before surgery.
c.Stop giving top feeds and cow or buffalo milk 6 hours prior to hypospadias surgery.
d.Sips of clear liquids like plain water, Oral Rehydration Solution (ORS) or glucose water can be given till 1 hour before corrective surgery for hypospadias.
On the Day of Hypospadias Surgery:
1.Intravenous (IV) Access:
- If your child is cooperative, an IV line may be placed outside the operating theatre.
- If your child is too anxious or cranky, your child will be given a mild sedative syrup to reduce anxiety 20-30 minutes before surgery. Keep your child under supervision after they have taken the syrup. Thereafter, the IV line will be placed after they are under general anaesthesia.
2.Preoperative Counselling:
You child, along with you, will be called to the preoperative holding area immediately prior to surgery. There, a quick pre-anesthesia examination will be conducted, followed by a detailed instructions and any doubts you have will be addressed. From there, your child will be taken to the operating theatre without you. Parents aren’t allowed inside the operating theatre as it is a sterile environment to prevent infections.
3.General and Regional Anaesthesia:
- Your child will receive general anaesthesia and possibly regional anaesthesia for better pain relief post hypospadias surgery.
- The regional anaesthesia given in hypospadias is caudal analgesia which is an injection given in the lower back in the epidural space.
- This gives good pain relief for 8-10 hours after surgery.
- Expect temporary sensory loss or immobility in the lower limbs for 8-10 hours post-surgery due to regional anaesthesia.
- In addition, your child will receive IV painkillers, antibiotics and medications to prevent nausea & vomiting
Post-operative Care:
1.Recovery Room:
- Your child will be brought in the recovery room in sleepy state to decrease anxiousness post-surgery.
- They will be monitored for pulse rate and oxygen saturation and will receive oxygen support and possibly nebulization to prevent throat dryness.
- IV fluids will continue during the recovery period.
- You may stay with your child in the recovery room.
2.Awakening:
- Your child will become fully conscious within 30 minutes to 2 hours after surgery.
- They will be assessed for pain, nausea, and vomiting.
- Once we are fully assured, your child will be shifted back into the room.
3.Postoperative Feeding:
- After 1.5 to 2 hours post-surgery, if your child is full awake and does not have any nausea, they may start with clear water.
- If clear water is tolerated without nausea or vomiting, you can introduce juices and semi-solid food.
- Children taking mother’s milk can be given milk after child is fully conscious as per doctor’s advice. Care has to be taken that child is burped adequately after feed.
4.Pain Management:
- Your child’s pain will be managed with IV and oral painkillers. We also give bladder spasm relieving medications.
- If they experience nausea, vomiting, or fever, appropriate medications will be administered as needed.
Please ensure your child is not left unattended at any point during this process, especially after sedation and during the post-operative period.
At Hypospadias foundation India, we have been taking care of children and adults with hypospadias for last 16 years with best-in-class results. We have a team of pediatric anaesthesiologists at hypospadias foundation who gives anaesthesia for all hypospadias surgeries. Our anaesthesiologist works closely with the hypospadias surgeon and other members of the surgical team to ensure the child receives safe and effective care throughout the entire surgical experience. the expertise of anaesthesiologist ensures patient’s comfort and safety from pre surgery to post surgery period. Dr A.K.Singal is currently rated as the best hypospadias surgeon expert in India for such cases. Dr Singal works along with Dr Ashwitha Shenoy in MITR Hospital Navi Mumbai which is the best hypospadias hospital in India.