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Hypospadias
Guidelines
Key sources
The following summarized guidelines for the evaluation and management of hypospadias are prepared by our editorial team based on guidelines from the European Association of Urology (EAU/ESPU 2025), the Canadian Urological Association (CUA 2017), and the American Urological Association (AUA 2014).
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Diagnostic investigations
Perioperative care
Preoperative hormonal therapy: as per EAU/ESPU 2025 guidelines, consider offering preoperative androgen stimulation therapy to increase penile length and glans circumference
C
in pediatric patients with proximal hypospadias and a small appearing penis, reduced glans circumference or reduced urethral plate. C
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Perioperative antibiotics
Surgical interventions
Surgical repair, timing
As per EAU/ESPU 2025 guidelines:
Consider performing primary hypospadias repair at age of 6-18/24 months.
C
Recognize that age at surgery is not a risk factor for complications in prepubertal patients undergoing tubularized incised plate urethroplasty repair.
B
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Surgical repair (penile curvature correction and urethroplasty)
Surgical repair (dressing)