What are the problems relating to surgery?

The extent of complications following hypospadias surgery is obviously related to how complex the surgery was. However there are some commonly occurring problems:

• In most operations the surgeon is attempting to move the opening on the penis (the urethral meatus) from its original position on the shaft to the tip of the penis. However, the original opening sometimes reopens and may then leak urine and semen. This is referred to as a fistula, and will probably need further surgery.
• In some men, a narrowing of the tube that carries urine and semen (the urethra) occurs after surgery. This narrowing or stricture (stenosis) can cause a decrease in the force of the urine stream and/or ejaculation. Mild strictures can usually be eased by using an instrument that will gradually widen the tube.
• Sometimes the new opening becomes smaller than it was after surgery (this is known as a meatal stenosis). This can often be dealt with by inserting an instrument that is larger than the opening, and gradually stretching it.
• In the older methods of hypospadias repair, a skin graft using skin with hair was used to repair the hypospadias, and these hairs could form blockages or infections in the urethra. In modern repairs, non-hair bearing skin is used.
• A man may develop urinary tract infections if he has problems urinating after the operation.