Post-Operative Instructions: Hypospadias

When your child is discharged, his penis will be covered with a clear bandage and may appear red, swollen, or bruised.  He will have stitches visible on his penis. There may be a silicone urethral tube going into the bladder if needed for your child that will drip urine into a diaper continuously.  The tube may move a little bit; do not worry as long as it is dripping.  The tube may cause bladder spasms in some children.  Not all children get them, but you should suspect them if your child is irritable despite Tylenol or he draws his legs up.

The medication Ditropan is designed to help this problem.  It may cause red cheeks, dry mouth and a low-grade fever.  Ditropan is not needed if your child is comfortable.  Your child will have a clear plastic “band aid” around his penis.  This may come off by itself; if it does not, do not worry; it will be removed in the office.  When the band-aid is off you should apply Bacitracin or Neosporin ointment (DO NOT use pain relief Neosporin) to the penis (very important).  You may see a tannish film form on the tip of the penis.  Do not worry, this is normal and is not an infection.

WHEN TO CALL THE DOCTOR
If you see an increased amount of swelling, redness, bleeding, or a pus-like drainage; if the tube is not draining normally; or if there is a large amount of bright red bleeding, you should call.

DIET
Start with clear liquids-soup, Kool-Aid, Pedialyte, pop or juice (breast milk is considered a clear liquid), and progress gradually to a normal diet. If taking formula, try half-strength formula first (half water/half formula) and then progress to full strength. He may take regular food only after he is tolerating full strength liquids well (usually the day after surgery)

ACTIVITY
For the first 3-4 weeks your child should play quietly and avoid roughhousing, running, climbing, bike riding, swimming, straddle toys etc. for 3-4weeks. Avoid anything that could traumatize the penis for 4 weeks.  It is important to remember that your child may feel better before healing is complete.

BATHING
Your child may not take a bath or shower until the urethral tube is out.  You should apply Bacitracin or Neosporin ointment to the penis once the bandage comes off (DO NOT use pain relief Neosporin).  Do not use any powder.  If your child has a bowel movement wash liberally with a moist washcloth.

PAIN
Pain should be relieved with Tylenol.

Dose:  
4-11 months 80 mg  = four times/day  
12-23 months 120 mg = four times/day 
Over 2 years Read dosage instructions on bottle  

You will also receive a prescription for Tylenol with Codeine to use if regular Tylenol does not help to relieve the discomfort.

MEDICINE
You will be given a prescription for a urinary antibiotic, Ditropan and Tylenol with Codeine.

FOLLOW-UP APPOINTMENTS
Call our office at (248) 519-0305 for an appointment one week following surgery or if you are concerned something is not right.