Genital Reconstruction & Revision
Problems in adults after childhood hypospadias repair, including strictures, fistulas, and curvature, and how revision works.
Written and reviewed by Shervin Badkhshan, MD · Last reviewed
November 2026
Part of:
Urethral strictures
Outpatient or 1 night
Fellowship-Trained Reconstructive Urology
AT A GLANCE
From symptoms to treatment
1. SYMPTOMS
• Spraying or weak stream • A second opening that leaks • Curvature
3. TREATMENT
• Fistula repair • Straightening • Urethral reconstruction, sometimes in stages
Surgical options →
Hypospadias is a condition present at birth where the urethral opening sits on the underside of the penis instead of the tip. Most men had it repaired as children. I see adults whose childhood repair has caused problems later, or who never had it repaired.
Problems I see in adults
A narrowed urethra (stricture) after a prior repair
A fistula, a second opening that leaks urine
A spraying or deflected stream
Curvature that persists or returns
Hair-bearing skin inside the urethra causing infections or stones
How I evaluate it
An exam, a flow test, and often a retrograde urethrogram and cystoscopy to see the length and quality of the urethra. Records of your childhood surgeries help if you can get them.
Treatment
Revision is tailored to the problem: repairing a fistula, straightening a curve, or rebuilding a narrowed urethra, often with a graft from inside the cheek and sometimes in two stages. If nothing bothers you, no surgery is needed.
Related
Urethroplasty · Second opinions and failed prior repairs · Cheek graft mouth care
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