Hypospadias in Baby Boys: Don't Circumcise

Dr. Tanmay Motiwala
Pediatric Surgeon, Raipur · Updated 30 Sep 2026 · 6 min read

For most parents, the first time they hear the word “hypospadias” is in the newborn ward. Or a grandmother may notice that the baby’s urine goes downwards, not forwards. The mother nearly always feels guilty and asks: “Did I do something wrong in pregnancy?”

The honest answer is no. Hypospadias is one of the most common birth differences in boys. Nothing the mother did caused it. And with the right surgery, the long-term result is excellent. So here are the key points every parent should know.

What Is Hypospadias?

In a normal penis, the hole for urine (wee) is at the tip. The foreskin fully covers the head, and the shaft is straight.

However, in a boy with hypospadias, three things happen together:

The urine hole sits on the underside of the penis. It can be anywhere from just below the tip down to the scrotum (the skin bag that holds the testicles).
The foreskin is incomplete on the underside. So it forms a “hood” only on the top.
Also, the penis often has a downward curve when it is stiff (erection). Doctors call this chordee.

It happens as the baby grows in early pregnancy. In most cases, it does not run in families, and it is not something a mother causes.

How Common Is Hypospadias?

About 1 in every 200 to 300 baby boys has hypospadias at birth. This is far more common than most parents think. Also, the result with modern surgery is very good.

The One Rule Every Parent Must Know: Do Not Circumcise

I cannot say this strongly enough.

Do NOT circumcise a newborn boy with hypospadias. Not for any reason, and not until a pediatric urologist has checked him.

Why? Because the foreskin is the single most useful piece of skin for the repair. The surgeon uses it to rebuild the missing part of the urine tube (urethra). It also covers the underside of the penis. Once it is gone, the repair is much harder and the result is worse.

So if your baby’s doctor spots hypospadias after birth, put off any planned circumcision. First get the opinion of a pediatric urologist.

Best Age for Hypospadias Surgery

The right time is between 6 and 18 months of age. But most pediatric urologists prefer 6 to 12 months. Here is why:

The baby is still in nappies, so care after the operation is easy
The child does not move around much yet and will not pull at the dressings
It is before the child becomes aware of his private parts, so it does not upset him

There is no gain in operating in the first weeks. And there is no gain in waiting until school age.

What Does the Surgery Involve?

The exact method depends on where the opening sits and how much curve the penis has. In most cases:

It is a single-stage day-care or short-stay operation. The child is fully asleep (general anaesthesia)
The surgeon brings the opening to the tip, straightens the curve, and uses the foreskin to rebuild the missing part
A small tube (catheter or stent) stays in for a few days
Then most children recover comfortably at home, with a follow-up visit in a week

For more severe forms (where the opening is near the scrotum), we may plan the repair in two stages, six months apart. Also, we will go through the exact plan with you at the first visit.

Risks of Hypospadias Repair

I believe in being honest. Overall, problems happen in about 10 to 20% of operations. The risk also goes up when the original problem is more severe.

The most common one is a tiny leak between the new urine tube and the skin (a fistula). It happens in under 5% of mild cases, and more often in severe ones. A small second operation can fix most of these problems.

We plan for one operation. But there is a small chance your son may need a touch-up later, and you should know that.

The Long-Term Outlook — The Reassuring Part

When an expert does a modern repair:

The new urine tube grows with the child through puberty
The urine stream points forward, so your son will stand and pass urine normally
In adult life, sex and the ability to have children stay normal
The scar hides along the natural middle line of the penis

In fact, most men who had hypospadias repair as babies lead fully normal sex lives and can have children.

Common Questions About Hypospadias

Did I cause this during pregnancy? No. Please let go of this guilt. It is not your fault.

Will my child pass urine normally? After repair, yes. So he will stand to pass urine, with a forward stream.

Will sexual function be normal as an adult? In the vast majority of cases, yes.

Does it run in families? It can. If a boy has hypospadias, the risk for his brothers is about 6–21%. For his father, it is about 1–8%. But most cases still happen with no family history.

Can we wait until he is older to decide? Best not, because the 6–18-month window gives the best results, both for the body and for the mind.

When to See a Pediatric Urologist

Book a visit as soon as you or a doctor suspect hypospadias, ideally in the first few weeks of life. At the first visit, we will:

Confirm the problem and grade how bad it is
Cancel any planned circumcision
Check both testicles and the scrotum
Plan the timing of surgery (usually 6–12 months)

For mild hypospadias near the tip (distal hypospadias), the road ahead is short and the outlook is excellent. For more severe forms, the road is longer. But with expert care, a penis that looks and works normally is well within reach.

Dr. Tanmay Motiwala is an AIIMS-trained pediatric surgeon and pediatric urologist practising in Raipur, Chhattisgarh. He performs single-stage and two-stage hypospadias repair, with attention to cosmetic and functional outcomes. To book a consultation, visit the Contact page or call the clinic directly.

Related reading: Undescended Testis in Children | Phimosis in Boys: When Does Tight Foreskin Actually Need Treatment? | Preparing Your Child for Surgery

Sources: Hadidi — Hypospadias Surgery; Coran’s Pediatric Surgery (7th ed); Kelalis-King-Belman Clinical Pediatric Urology; Rob & Smith Operative Pediatric Surgery (7th ed). Further reading for parents: Hypospadias, Great Ormond Street Hospital.

📋 This article is part of Dr. Motiwala’s Pediatric Urology in Raipur services — see the full range of conditions treated, what to expect, and when to see a pediatric surgeon.

Hypospadias in Newborn Boys: Why You Must Not Circumcise — and When to Plan Surgery