Hypospadias - Post-Operative Care

WHILE YOU ARE STILL IN THE HOSPITAL

• Following surgery, your son will be encouraged to drink clear liquids when he is fully awake.
• He will be discharged home from the hospital when he is tolerating the fluids without vomiting. Nausea and vomiting are common reactions to the anesthesia, And can occur for 24 hours.
• Do not worry if you see a little blood spotting at the tip of the penis or on the dressing.
• If your child received a “baby spinal” his legs and feet may be a little numb and move less than usual. Do not worry. All sensation will return.
• You are encouraged to talk and touch your son while in the recovery room.

UPON YOUR ARRIVAL HOME

Diet

• You may feed your son juices, Jello and clear broth for the first post-operative day/evening.
• A regular diet may be resumed the next morning or earlier if tolerated.
• Do not force feed, especially if your child is nauseous. His appetite will return to normal with time.

Dressing

• The penis is wrapped in a special bandage. This bandage will be removed in the office according to your doctor’s specific instructions.
• Do not worry if you see a little blood spotting through the bandage.
• Try to keep the bandage and surrounding areas clean with frequent sponge baths.
• Do not be concerned if the bandage becomes soiled with stool or urine. It will also be smelly. The penis will not get infected.
• If the dressing comes off, please notify the doctor. Do not try to put the bandage back on.
• Bacitracin ointment, Triple Antibiotic Ointment or Neosporin are all suitable to use on the penis or at the tip of the dressing.

Diapers

• Double diaper your son for added protection (see: Making a double Diaper)
• Prepare several double diapers in advance of the surgery date.
• Continue to place the urinary tube and penis into the diaper as directed by your doctor and nurse.
• Change your son’s diapers more frequently during the first post-operative week.

Tube in Penis

• There may be a tube that passes through the penis into your son’s bladder. This tube may be sewn in place. This is used to drain the urine continually from his bladder so that your child does not need to urinate. He may, however, feel the “urge” to urinate because the tube can irritate the bladder. He will be on a medication called oxybutinin (Ditropan) to help relieve this urge and the associated bladder “spasms”. Bladder spasms are not dangerous.
• The bladder spasm may cause some leaking or “spraying” of urine AROUND the tube. This is common and the oxybutinin (Ditropan) medication will help this.
• Do not let the tube become “kinked or bent” as this will prevent the free flow of urine.
• Do not push or pull on the catheter-be careful during diaper changes.
• Remember-the tube is in the bladder and draining urine. Urine will flow from the catheter during diaper changes.
• Bleeding may occur with hypospadias repair. Minor spotting in diaper and seeing blood in catheter is not unusual and should stop after a few days.

Bladder Spasms

• Bladder spasms occur from the tube irritating the bladder as well as from the normal healing process.
• Signs of spasms include: arching of your child’s back with associated irritability, spraying of urine through and around the tube, a sudden awakening from a sound sleep and severe urge to urinate.
• For the occasional spasm try holding and comforting your child.
• For spasms that are more frequent, your doctor has prescribed oxybutinin (Ditropan)
• Constipation will make the spasms very severe. The oxybutinin AND the codeine are constipating. Make sure your son has daily soft bowel movements. If you notice a change in his bowel habits, start with straight apple juice of dilute prune juice. Try some baby prune sauce. Add fiber.
• Avoid pasta and dairy.

Medications

• You may give your son Tylenol (acetaminophen) for any pain or discomfort.
• For severe pain your doctor may have prescribed Tylenol with codeine.
• Ditropan (oxybutinin) is a medication that relieves bladders spasms. Use it as directed by your doctor.
• Antibiotic should be administered as directed by your doctor.
• Pyridium (phenazopyridine) is a medication that relieves urinary burning. This will temporarily turn your child’s urine and tears orange. Use it as directed by your doctor.

Activities

• Carry your child so that he is supported under his behind. No pressure should be placed on his penis area!
• NO straddle toys (bouncers, bicycles, tricycles and rocking horses) for at least ten days unless otherwise directed by your doctor. Do not carry patient on your hips.
• Infant/child car seats, strollers and high chair may be used.
• Your child may ride in the car, take walks as tolerated and walk up and down stairs.
• “Mommy and Me” activity classes restriced for 3 weeks if the catheter is no longer in place.

Post-Operative office visit

In case of emergency