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Prof. Dr. Ali Avanoğlu
Hypospadias Surgery • After Surgery

Wound Opening After Hypospadias Surgery (Glans Dehiscence)

The stitches at the tip of the penis have opened and the opening has shifted back again. This is the most visible form of a repair breaking down, and correcting it requires a new repair.

Who this is forCases with opening at the tip
Reading≈1 min
ByProf. Dr. Ali AvanoğluUpdated
This page is part of hypospadias surgery.Read the full treatment overview on the hub page
Opened
Normal
urinary opening
01 · Why does it happen?02 · Why is waiting necessary?03 · Repeat repair
In brief3 madde
  • Why does it happen?: The most common cause is tension at the time of closure.
  • Why is waiting necessary?: As the separated area heals, it forms tissue that is hard and poorly perfused.
  • Repeat repair: For limited separation: the wings of the glans are released more widely and closed without tension.
01

Why does it happen?

The most common cause is tension at the time of closure. If the glans is small, or if the two halves were not released enough, the stitches stay under constant tension throughout healing and eventually open. Infection and swelling speed up this process.

  • This is not caused by a mistake made at home.
02

Why is waiting necessary?

As the separated area heals, it forms tissue that is hard and poorly perfused. A procedure performed before this tissue softens is very likely to open again. Waiting at least 6 months is usually required.

03

Repeat repair

  • For limited separation: the wings of the glans are released more widely and closed without tension.
  • If the channel is also affected: the opening and the final part of the channel are reconstructed together.
  • If tissue is insufficient: the bed is prepared with a graft, and the channel is built in a second session.
  • In every case: removing tension is the most critical principle for preventing the wound from opening again.
Hypospadias Surgery video guide19 short videos, in order
Frequently asked questions
What is done if the glans is small?
A short course of pre-operative testosterone treatment can enlarge the tissue and make tension-free closure easier. This is an option to discuss with your surgeon.
Could this happen again?
If the tension isn't eliminated, the risk continues. This is why the priority in a repeat repair is less about technique and more about ensuring the tissue is not left under tension.
Prof. Dr. Ali Avanoğlu's publications on this topic · 1
  1. Ulman I, Erikçi V, Avanoğlu A, et al. (1997). The effect of suturing technique and material on complication rate following hypospadias repair. European journal of pediatric surgery. PubMed ↗
←Previous • After SurgeryAfter-Surgery Care GuideNext • After SurgeryFistula After Hypospadias Surgery→
Related pagesFull index →
Recurrent CasesRedo Hypospadias SurgeryMultiple procedures have already been performed, and the problem persists. This is the most demanding area of hypospadias surgery, and by this stage the plan is no longer built around standard techniques but around an inventory of the tissue that remains.Surgical TechniquesPre-Operative Testosterone TreatmentIn some cases, a short course of hormone treatment is given before surgery. The goal is to enlarge the penis and the surrounding tissue somewhat, making the repair technically easier.Surgery in ChildrenTwo-Stage Hypospadias SurgeryStaged repair is not a second surgery performed because of a complication — it is two steps planned from the very start. The first session prepares the foundation, the tissue matures during the interval, and the channel is built in the second session.After SurgeryCosmetic Evaluation After Hypospadias SurgeryUrine flow is fine; the concern is about shape, symmetry, or the appearance of the opening. This request is legitimate and can often be met — but its timing and scope need to be discussed carefully.
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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