Timing of Hypospadias Surgery: Why the Calendar Is Not the Surgeon

Hypospadias timing is often reduced to a simple age window: six months, twelve months, eighteen months.This episode argues that timing is not only a calendar decision. It is a readiness decision.We discuss the four clocks that should guide surgical timing: anesthesia readiness, tissue readiness, phenotype readiness, and family readiness.The episode focuses on how timing changes in distal versus proximal hypospadias, why staged repairs must be planned as a sequence, when endocrine evaluation should come before reconstruction, and why the “standard age window” should not replace expert surgical judgment.This episode is part of Season 4 of Pediatric Urology Academy: Hypospadias — Anatomy, Judgment, and Reconstruction.