Redo Hypospadias: When the Tissue Has Already Lost Trust

Redo hypospadias is not primary hypospadias repeated.The anatomy may look familiar, but the biology has changed. Scar, altered vascularity, consumed dartos, stiff glans wings, recurrent curvature, strictures, diverticula, fistulas, and prior tissue choices all change the operation.This episode reframes redo hypospadias as a different reconstructive disease.We discuss a five-failure framework: flow failure, tissue failure, coverage failure, curvature failure, and expectation failure.The goal is not simply to close the visible defect. The goal is to understand why the previous repair failed before creating the next repair.This episode is part of Season 4 of Pediatric Urology Academy: Hypospadias — Anatomy, Judgment, and Reconstruction.