Most boys born with hypospadias have an incompletely formed foreskin on the top of the penis but missing underneath. The appearance of the foreskin is what alerts health care providers in the newborn nursery that a boy may have hypospadias.
One reason for hypospadias repair is to either remove the partial foreskin to achieve circumcision, or to repair the foreskin so that the penis looks natural. Left the way it is at birth, the penis will look neither circumcised nor natural. This difference can bring unwanted attention to the boy later in life when changing in a locker room, or during sexual encounters.
Preferences for circumcision versus a natural foreskin vary around the world. For example, in the Middle East circumcision is nearly always desired, while in Europe circumcision is much less common and may make a boy stand out as different. Boys growing up in the US will be around both circumcised and uncircumcised boys.
Surgeons doing hypospadias operations should be able to do either a circumcision or a repair of the foreskin, according to the wishes of the parents. Dr Snodgrass and Dr Bush analyzed the PARC Urology database of hypospadias surgical results and found that they were the same regardless of which was done. At PARC Urology, they simply ask parents which they prefer and then do that.
Some care-givers have been told by other pediatric urologists that foreskin repair increases the chance for a hypospadias repair complication. Some pediatric urologists simply refuse to do a foreskin repair.
Many publications verify the reports by Dr Snodgrass and Dr Bush that the results of hypospadias surgery should be the same whether circumcision or foreskin repair is done. Care-givers who desire a natural look for the penis may have to seek out a hypospadias specialist such as those at PARC Urology to have foreskin repair for their son.