Hypospadias Repair
Expert Adult & Adolescent Hypospadias Reconstruction
Hypospadias is a congenital condition in which the urethral opening is located on the underside of the penis rather than at the tip. While most cases are repaired in childhood, some men reach adulthood with uncorrected hypospadias, cosmetic or functional concerns from prior surgery, or complications requiring revision reconstruction.
Dr. Alex J. Vanni is a nationally recognized reconstructive urologist with extensive experience in adult and adolescent hypospadias repair, including complex primary cases, failed prior repairs, and reconstruction for urethral stricture, fistula, or chordee. Patients are referred nationally for his expertise in achieving functional and cosmetic outcomes in challenging cases.
What Is Hypospadias?
Hypospadias occurs when the urethra does not fully develop during fetal growth, resulting in an opening along the underside of the penis. The severity depends on the location of the urethral opening:
Distal Hypospadias
Opening near the tip of the penis (glandular or subcoronal)
Mid-Shaft Hypospadias
Opening along the penile shaft
Proximal Hypospadias
Opening near the base of the penis or scrotum (penoscrotal or perineal)
Many men with hypospadias also have associated penile curvature (chordee), which can interfere with sexual function if not corrected.
Adult and Adolescent Hypospadias
Men may seek hypospadias repair in adulthood for several reasons:
- Uncorrected hypospadias from childhood
- Cosmetic concerns or dissatisfaction with appearance
- Functional problems with urination or sexual activity
- Complications from prior childhood surgery (stricture, fistula, persistent chordee)
- Failed or incomplete prior repairs
Adult hypospadias reconstruction requires specialized expertise in complex urethral surgery and penile reconstruction.
What Are the Symptoms of Hypospadias?
Men with hypospadias may experience:
- Abnormal urinary stream direction (downward or spraying)
- Difficulty with standing urination
- Penile curvature (chordee) affecting intercourse
- Cosmetic concerns or self-consciousness
- Urethral stricture or fistula from prior surgery
- Recurrent urinary tract infections
Even mild hypospadias can have functional or psychological impacts, and surgical correction can significantly improve quality of life.
How Is Hypospadias Diagnosed?
A thorough evaluation includes:
- Detailed history of prior surgeries and outcomes
- Physical examination to assess urethral location, chordee, and tissue quality
- Assessment of urinary function and sexual function
- Evaluation for complications such as stricture or fistula
- Discussion of patient goals and expectations
Careful preoperative planning is essential to selecting the most appropriate reconstructive technique.
How Is Hypospadias Repaired?
Hypospadias repair is tailored to the severity of the condition, prior surgical history, and individual anatomy.
Surgical Approaches
Primary Hypospadias Repair
For adults with uncorrected hypospadias, surgery involves:
- Creating a new urethra to extend to the tip of the penis
- Correcting penile curvature (chordee) if present
- Reconstructing the glans and urethral opening for normal appearance
Revision Hypospadias Surgery
Men with complications from prior childhood surgery may require:
- Repair of urethral strictures
- Closure of urethrocutaneous fistulas
- Correction of persistent or recurrent chordee
- Redo urethroplasty with grafting or flap techniques
Staged Reconstruction
Complex cases, particularly those with extensive scarring or poor tissue quality, may benefit from staged reconstruction performed over two or more operations to optimize outcomes.
Goals of Hypospadias Repair
The primary objectives of surgery are to:
- Create a straight penis without curvature
- Position the urethral opening at the tip of the penis
- Achieve a functional urinary stream
- Restore normal cosmetic appearance
- Preserve or improve sexual function
What Can I Expect During Recovery from Hypospadias Repair?
Recovery from hypospadias repair typically involves:
- Catheter placement for 1-3 weeks to allow healing
- Wound care and activity restrictions
- Gradual return to normal activities over 4-6 weeks
- Follow-up to monitor healing and function
Success rates are high when surgery is performed by experienced reconstructive urologists, with most patients achieving excellent functional and cosmetic outcomes.
Why Experience Matters in Hypospadias Repair
Adult hypospadias reconstruction is technically demanding and outcomes depend on:
- Expertise in urethral and penile reconstruction techniques
- Experience managing scarred or compromised tissue from prior surgery
- Thoughtful surgical planning and technique selection
- Commitment to both functional and cosmetic outcomes
High-volume reconstructive experience improves success rates and reduces the need for additional procedures.
Dr. Vanni's outcomes reflect a commitment to technical excellence, patient safety, and long-term satisfaction in both primary and revision hypospadias cases.
National Referral Center for Adult Hypospadias
Adults and adolescents with uncorrected hypospadias or complications from prior repair are referred nationally to Dr. Vanni for expert evaluation and definitive reconstruction. He works closely with referring physicians to provide comprehensive care and coordinate long-term follow-up.
Have Questions About Hypospadias Repair?
Get answers to the most common questions about hypospadias repair treatment, surgery, and recovery.
View Frequently Asked QuestionsAdult hypospadias repair techniques are informed by decades of peer-reviewed research, and Dr. Vanni's surgical approach reflects current evidence-based best practices and AUA guidelines.
Treatment Outcomes at a Glance
Success Rate
Over 90% success rate including revision cases
Surgery Duration
Outpatient surgery. Taking 2–4 hours for both primary and complex revision cases
Recovery
Return to desk work within a week; physical restrictions 4–6 weeks
Schedule a Consultation
If you have uncorrected hypospadias, concerns about prior surgery, or functional or cosmetic issues affecting your quality of life, expert evaluation can help determine the most effective treatment approach.