Hypospadias is a common malformation in male children, and its occurrence is associated with the advanced age of the mother, abnormalities in fetal endocrine secretion, use of maternal progesterone, changes in the surrounding environmental factors caused by various kinds of pollution, excessive alcohol consumption by pregnant women and premature birth, and malformations of the uterus and placenta. Most of the affected children are successfully cured at an early age, but some of them fail the surgery at an early age or are not treated in time due to various reasons such as economic conditions, and only realize the seriousness of the problem after the development of secondary sexual characteristics in adulthood. Therefore, in adults with hypospadias, we generally refer to male patients who have developed secondary sexual characteristics or are older than 18 years old. While the key to successful repair requires comprehensive knowledge of hypospadias repair, the patient’s own local conditions such as the degree of penile recurvature, the position of the urethral opening, the size of the penile head, the local foreskin and the development of the distal urethral plate are more important. Adult hypospadias surgery is more prone to complications because of some of the following characteristics. First, most patients have had multiple surgeries in local hospitals in their early childhood, but the surgeries failed for various reasons, so that when they are operated on again in adulthood, there is little local foreskin material or much local foreskin tissue scarring in the penis, making it difficult to reshape the urethra using the local foreskin. Adult penile scrotum local skin follicles more, easy to hide more bacteria, hair follicle sebaceous gland secretion serious, urethral secretions increased, the chance of infection increased. Secondly, the presence or absence of penile curvature is also particularly critical to the success or failure of the patient’s re-operative urethroplasty. Thirdly, adult patients have a long operation time, patients have multiple operations to make local adhesions, more scar tissue, and the penis has developed, so there is more bleeding during the operation, and the adult has a longer anterior urethral defect after the penile recurvature is corrected, making the operation time long. Fourth, the adult postoperative penile erection is more troublesome, after the sexual development of the patient’s penis development volume increases, more likely to produce penile erection, especially at night, after surgery, such as frequent repeated erection of the penis will make the penis local wound tension, easy to make the forming urethra, local penile wound split, surgery failure. Fifth, the increase of urethral secretions after surgery, the adult urethra will produce a large amount of secretions every day, because of the indwelling catheter these secretions are not easy to discharge with urine, such as these secretions remain in the urethra for a long time, it is easy to occur in the urethra infection, and even local wound subcutaneous infection, so that the operation fails. Finally, staged surgery has an important place in adult patients, and it is advisable to consider staged surgery in cases of curved deformities that require extensive dissection to resolve, and in cases of penile dysplasia accompanied by a severe shortage of reconstructive materials. To address these characteristics, certain measures are taken before and after surgery to improve the success rate of surgery. First, a careful medical history should be taken before surgery to understand the history of previous surgeries and to clarify the present condition of the penile skin and urethra through physical examination to roughly design the surgical plan. The skin should be prepared from 3 days before surgery, and the local penile and scrotal skin should be scrubbed and disinfected every day. Secondly, the penis must be injected with water and erection test first during the operation, and correcting the bending of the penis is the basis of success. The operation should be performed gently, using small forceps and scissors, and the tissue should be kept moist and active during the operation, and attention should be paid to protecting the blood supply of the surrounding tissues. Finally, the postoperative penile wound pressure dressing to strengthen observation and care, postoperative pressure dressing loosely and tightly appropriate is more critical. Postoperative routine application of estrogen for 5-7 days to prevent penile erection, postoperative should keep the external urethral catheter clean, and local flushing of the urethra with gentamicin is essential to prevent infection.