Some first degree cases are so mild that they do not require treatment but these are fairly rare. The majority of cases require surgical repair.

The objective is to relocate the urethral opening to its normal position on the tip of the penis and to correct any abnormal penile curvature.

There is also the goal to produce an aesthetic result as close to resemblance of a normal penis as possible.

The surgery can range from relatively simple to complicated. Severe cases may require multiple visits to theatre producing progressive repair results. The principle objective is however to achieve a single stage repair in order to avoid the risks associated with multiple operations.

The reconstructive nature of the repair, depending on its severity, may utilises the foreskin. For this reason it is imperative that a circumcision not be carried out on the child until the hypospadias repair takes place.

This requirement must be carefully balanced with religious requirements. For example, the Jewish bris should be coordinated with the hypospadias repair. This is achievable by attendance of the mohel in theatre to ensure religious observance takes place.

The timing of the surgery is important to avoid memory of the event and associated psychological factors. Depending on each case, and relative severity, this is carried out between 6 to 18 months. Earlier interventions reduce the likely impact from a psychological point of view.

The repair requires administration of a general anaesthetic and the overall health of the child is assessed for this risk.