A mother asks about the plan for her infant son born with distal penile hypospadias. Which statement regarding management is correct?

• A Circumcision must be avoided because the foreskin is used in the repair ✓
• B Circumcision should be done at birth so the repair can use healthy skin later
• C Repair should be deferred until the child starts school to allow tissue growth
• D Hormone therapy is required in all cases before surgical correction

Explanation

The foreskin provides skin flaps for urethroplasty and glansplasty, so circumcision is contraindicated until reconstruction is complete. Standard practice repairs hypospadias between roughly 6 and 18 months of age, when anaesthetic risk is low and memory is absent, well before school. Preoperative testosterone may be used in selected boys with a small phallus but is not universal. Deferring repair to school age is outdated and psychologically undesirable.

Reference: Bailey and Love's Short Practice of Surgery, 27th ed.

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Written and medically reviewed by the StethoPrep medical team.