Hypospadias is a common congenital problem which can be corrected by surgery. Post operative care of hypospadias surgery is equally important as it needs care of pain, infection, dressing and urinary tube (catheter).
Post operative care after hypospadias repair Includes :
The child will require analgesics, usually paracetamol for surgical site pain. He may have spasmodic pains because of the urinary catheter which can sometimes irritate the bladder wall. To prevent this child will be given anticholinergic drugs (Tropan).
Besides the child will be given antibiotics to prevent the risk of infection and laxatives in case of constipation.
The most important is to take care of urinary pipe (catheter). We prefer using double diaper in children less than 3 years old. The diaper which is inside needs to be changed if it gets soiled with stool while the outer diaper which soaks urine needs to be changed on regular basis. The purpose of using double diaper is to avoid mixing of stool and urine and thus avoiding the risk of infection.
Parents should ensure that the catheter is continuously draining urine. They can check this by changing the diaper regularly or emptying the urinary bag in regular intervals. In case the catheter is not draining the urine, one should check for any kinking of the catheter, if this is not the possibility then they have to contact the doctor or report in the emergency. Sometimes the blocked catheter may require flushing with saline.
In case if dressing gets soaked with urine you can use a hair dryer to make it dry (at same time ensure that the catheter is draining urine).
The child will be called after 7 to 10 days to remove the dressing and catheter (or before if it gets soaked with blood or urine.)
He will not be able to take bath till the time catheter is removed, but careful sponging can be done.
After the dressing is removed, he can take shower. He will be advised for sitz bath and application of local antibiotic ointments for 10 days.
You should contact doctor/emergency if the child has lot of pain, dressing gets soaked or has fallen off and if catheter is not draining urine.