Hypospadias repair, post-op pharmaceutical management

Antimicrobial prophylaxis is recommended in all patients with a stent. Co-amoxiclav is a broad spectrum antibiotic that will cover the patient from several organisms.

Co-amoxiclav (Augmentin) 125/31 suspension

Co-amoxiclav (Augmentin) 250/62 suspension

Trimethoprim

If the patient has a history of UTI’s, is at a higher risk of UTIs or is allergic to penicillin, prophylactic Trimethoprim may be prescribed where appropriate. Dose for all ages is 1-2mg/kg at night.

Oxybutynin 2.5mg/5ml elixir

The prescriber must check the patient’s weight is appropriate for age before prescribing.

Paracetamol 120mg/5mL suspension

For first 48 hours paracetamol should be given regularly, after which time ‘when required’ paracetamol should be prescribed.

Refer to current BNFc for age based dosing of paracetamol

Ibuprofen 100mg/5mL suspension

If appropriate and required, prescribe ‘when required’ for all patients.

Refer to current BNFC for age based dosing of ibuprofen

Lactulose solution

If patient has history a of constipation or is suffering with symptoms of constipation lactulose should be prescribed when required.

Adjust dose according to response.

Staged repairs may also require the use of Normal Saline 0.9% for twice daily flushing of the catheter. Prescribe if appropriate for patient.

Unless surgery is extensive antimicrobial prophylaxis is not recommended. If surgery is thought to be extensive and patient at a high risk of infection, Co-amoxiclav should be prescribed as above in section 1.1.

Without the use of a catheter oxybutynin is not required.

Paracetamol and Ibuprofen should be prescribed if required as above in section 1.3.

If required lactulose should be prescribed as above in section 1.