Patrick H. McKenna, MD, FACS, FAAP, and Mercyhealth have established a regional center to manage all degrees of hypospadias, complex redo operations and other genitourinary abnormalities including chordee, epispadias and hidden penis. These problems can be managed by many physicians but the surgical outcome is improved with experience and a high-volume practice. Dr. McKenna’s approach is to minimize the number of procedures, improve results of the initial repair, avoid using graft material, utilize only preputial skin and mobilized urethra for repairs, avoid plication in correcting bend and using a coordinated team approach. He has popularized the urethral mobilization technique for repairs that is associated with a significantly decreased number of complications. He believes that a complete discussion of the expected outcome is important. For the more severe forms of hypospadias, pediatric patients and parents need to understand the important concept that hypospadias can be a lifelong medical problem.