Epispadias and Hypospadias

Epispadias is a condition in which the urethral orifice is located on the dorsal surface of the penis (often occurs with exstrophy or the bladder). In hypospadias the urethral orifice is located below the glans penis along the ventral surface.

Surgical intervention is done before the age of toilet training (preferably between 16 and 18 months of age) and the child should not be circumcised because the foreskin may be used in surgical reconstructions.

After surgery, the child will have a pressure dressing and may have some type of urinary diversion or a urinary stent that is used to maintain patency of the urethral opening while healing of the meatus occurs.

Postoperative Nursing Interventions:

• Monitor vital signs
• Encourage child fluid intake to maintain urine output and to maintain patency of the stent
• Monitor intake and output and the urine for cloudiness or a foul odor
• Notify the physician if there is no urinary drainage for 1 hour because it may indicate kinks in the system or obstruction by sediment
• Administer pain killer, anticholinergic and antibiotic as prescribed
• Instruct the parent to avoid giving the child a tub bath until the stent is removed (if any)