What is hypospadias?
Hypospadias is a congenital condition in boys where the urinary opening sits on the underside of the penis instead of the tip. Some children have a mild distal form, while others have a more proximal opening, a hooded foreskin, or a downward bend of the penis called chordee. Parents usually hear about it at birth, and the main questions are whether surgery is needed, when to do it, and whether the penis needs to be circumcised first.
Need a quick first review?
If your baby was just diagnosed, send the nursery note, pediatrician note, or a clear question on WhatsApp. Dr. Kallas Chemaly can advise whether the next step is observation, consultation, or planning for repair.
When should parents worry?
Hypospadias is usually not an emergency, but early specialist review matters because the first decisions affect the quality of the repair. Parents should seek pediatric urology review early if the stream sprays downward, the penis appears bent, or the diagnosis is associated with another genital difference.
- Do not proceed with circumcision before the child is examined.
- Urgent review is more important when hypospadias is associated with an undescended testis, difficulty urinating, or ambiguous genitalia.
- Persistent severe curvature may affect future function if left untreated.
How is the diagnosis confirmed?
Diagnosis is usually clinical and made on physical examination. Most boys do not need imaging. If the hypospadias is severe, proximal, or associated with an undescended testis or atypical genital appearance, ultrasound and occasionally hormonal or genetic testing may be recommended to rule out a broader difference of sex development such as DSD.
Treatment by age and severity
The usual window for repair is 6 to 18 months of age. Mild distal cases may need a straightforward single-stage operation, while proximal or redo cases may require more complex planning or staged repair. The goals are to straighten the penis, bring the urinary opening to the tip, and create a reliable urinary stream.
- Mild cases may be discussed in terms of function, not appearance alone.
- Most children who need surgery can be repaired in a single procedure.
- Complex anatomy may require foreskin tissue, which is why circumcision should be deferred.
What happens if we delay repair?
Delaying repair does not usually create an immediate emergency, but it can mean the child continues to have spraying of urine, persistent curvature, and later awareness of the difference in anatomy. In more severe cases, delayed treatment can make reconstruction more complicated and may postpone normal toilet training or standing urination.
What to expect before and after surgery
Families receive a plan covering anesthesia, the expected technique, catheter care, dressings, pain control, and follow-up. Many boys go home the same day or after one night. Swelling in the first week is common, and final healing is judged over several weeks rather than the first few days.
Before Surgery
Examination confirms severity, curvature, and whether one or two stages are likely.
First Week
A dressing and small catheter may stay in place briefly, with simple pain-control instructions for parents.
Follow-Up
Early review checks healing, and later review confirms stream quality, straightness, and long-term outcome.
Why families choose Dr. Kallas Chemaly
Dr. Kallas Chemaly has been treating complex primary and redo hypospadias cases for over 10 years, with a large volume of proximal and redo repairs averaging 30 cases per year. Hypospadias — and particularly the most difficult proximal and revision cases — is one of his core surgical focuses.
He takes a meticulous, anatomy-specific approach to hypospadias repair and explains each decision clearly in Arabic, French, or English. His fellowship training at Hôpital Robert-Debré in Paris and at two other European referral centers gives families access to expertise in both standard and complex reconstructions. For many families, the key advantage is having a surgeon who can explain what is urgent, what can wait, and what the realistic recovery looks like.
References
- Stanford Medicine Children's Health: Hypospadias in Children
- HealthyChildren.org: What Is Hypospadias?
- MedlinePlus Medical Encyclopedia: Hypospadias
Serving families across Beirut and Mount Lebanon
Dr. Kallas Chemaly treats children with hypospadias from Achrafieh, Gemmayzeh, Saifi, Sodeco, Verdun, Hamra, Clemenceau, Ras Beirut, Rabieh, Mtayleb, Brummana, Beit Mery, Bikfaya, Mansourieh, Kornet Chehwan, Antelias, Dbayeh, Jounieh, Kaslik, Hazmieh, Yarze, and across Keserwan, Metn, and Baabda.
Families visiting from the Gulf
Families traveling from Saudi Arabia, Kuwait, Qatar, Bahrain, Oman, or the UAE can share records before travel, organize consultation and surgery timing in Beirut, and plan follow-up around their stay.
Related Conditions
When to seek urgent care
Go to the nearest emergency department if your child has: sudden painful scrotal swelling (possible testicular torsion), inability to urinate for more than 8 hours, blood in the urine with fever or severe pain, high fever (above 38.5°C) with a known urinary abnormality, or trauma to the genitals. Do not wait for a scheduled appointment — request a pediatric urology consultation immediately.