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Prof. Dr. Ali Avanoğlu
Hypospadias Surgery • Hypospadias in Adults

Hypospadias Surgery in Adults

Not having had surgery until adulthood is not a disadvantage. In this group, the most important difference from children in the surgical decision is this: the goal is defined not by anatomy, but by your complaint.

Who this is forAdults who have never had surgery
Reading≈2 min
ByProf. Dr. Ali AvanoğluUpdated
This page is part of hypospadias surgery.Read the full treatment overview on the hub page
where it should beSubcoronal
underside view
01 · The complaint sets the goal02 · How adult tissue differs03 · Evaluation04 · Techniques and process
In brief4 madde
  • The complaint sets the goal: If the stream goes downward, the goal is correcting the stream; if the appearance is bothersome, the goal is correcting the appearance; if curvature makes intercourse…
  • How adult tissue differs: Adult tissue is thicker and less elastic than a child's, and its blood supply is different too.
  • Evaluation: The location and width of the opening, and the structure of the glans, on examination.
  • Techniques and process: TIP (Snodgrass) repair for a distal location; graft-supported repair if the groove is narrow.
01

The complaint sets the goal

If the stream goes downward, the goal is correcting the stream; if the appearance is bothersome, the goal is correcting the appearance; if curvature makes intercourse difficult, the goal is straightening. These three do not always call for the same operation.

  • This is why clearly defining, at the first consultation, the issue that limits you the most helps build the right plan.
02

How adult tissue differs

Adult tissue is thicker and less elastic than a child's, and its blood supply is different too. This does not mean repair is impossible; it means healing can take longer.

  • Quitting smoking before surgery is the single step that improves the outcome the most in this group. Getting blood sugar under control comes second.
03

Evaluation

  • The location and width of the opening, and the structure of the glans, on examination.
  • Uroflowmetry and measurement of urine remaining in the bladder after voiding.
  • A photograph taken from the side during erection — it makes assessing curvature easier.
  • Checking around the opening for signs of lichen sclerosus.
04

Techniques and process

  • TIP (Snodgrass) repair for a distal location; graft-supported repair if the groove is narrow.
  • If the only complaint is spraying, a limited meatoplasty may be enough.
  • For a proximal location, staged repair with oral mucosa is most common.
  • Surgery takes 1.5–4 hours; the catheter stays in anywhere from 7 days to 3 weeks.
Related videos
Full guide (19) →
Frequently asked questions
Is this too late an age for surgery?
No. Adult repairs are performed routinely and give good results. What matters is not age but the condition of the tissue and setting the right goal.
How much time will I need off work?
Return to a desk job is usually possible within 1–2 weeks. Follow your doctor's timeline for heavy work and sport.
When can I return to sexual activity?
Usually after 6 weeks, with your doctor's approval.
←Previous • Hypospadias in AdultsHypospadias + Penile Curvature in AdultsNext • Hypospadias in AdultsHypospadias and Fertility→
Related pagesFull index →
Hypospadias in AdultsHypospadias + Penile Curvature in AdultsIn adults, curvature is not only a matter of appearance: past 30 degrees it can make intercourse difficult and cause pain. The degree of curvature determines whether correction is needed before the channel repair.Hypospadias in AdultsRecovery Process in AdultsRecovery in adults takes a little longer than in children, but the process is predictable. The timeline below is a general framework; it varies with the scope of the repair.Surgical TechniquesOral Mucosa GraftThe thin layer of mucosa taken from inside the cheek is the most valuable backup tissue in hypospadias surgery. Because it tolerates a moist environment, and because it is thin and well supplied with blood, it is safely used as the lining for the new urinary channel.Hypospadias in AdultsHypospadias and FertilityThis is a topic that comes up often in hypospadias but is rarely discussed openly — and it is, to a large extent, a solvable problem.
Hypospadias Surgery topic clustersMain treatment page →
Basics 8Surgery in Children 8Surgical Techniques 5After Surgery 9Recurrent Cases 4Hypospadias in Adults 8Follow-up and Assessment 5
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