7.03.2008

HYPOSPADIAS



Hypospadias is a development anomaly in the male in which the urinary tract opening, or urethral meatus, opens the underside of the penis or on the perineum.


Etiology
The development of the penis place in early stages of pregnacy by the formation of the urinary channel and foeskin thanks to the stimulation of male hormones, various problems with hormone action may result in the congenital condition called hypospadias. in few cases, the cause of hypospadia in genetic.

Symptoms
Hypospadias is diagnosed most often during the initial newborn physical examination observing the urethral opening in a wrong position, combined in some cases with other symptoms :
  • Foreskin incompletely developed resulting in a dorsal hood (tip of the penis exposed)
  • penis curvature (chordee)
  • undescended tested
If left untreated, hypospadias can lead to an abnormal direction of the urine stream, abnormal appearance of the penis, infertility if the defect is located far enough away from the tip of the penis, and an inability to have sexual intercourse in cases involving chordee.

Diagnosis
Hypospadias is classified based on where tha urethral meatus is located

Therapy
The degree of hypospaidias and the extend of penile curvature will determine the necessity of a surgical intervention.

The surgery aims to create a normal straight penis with a urinary channel that ends at the tip of the head of the penis. the operation usually involves four steps : straightenig the shaft; creating the channel; positioning the urethral opening in the head and either circumcising or reconstructing the foreskin

Occasionally, when the opening is proximal, tratment with the male hormone testoterone previous to surgery may be recommended. Males who have hypospadias located within or near the scrotum should also have a procedure called a voiding cystogram to rule out additional urinary tract anomalies.

The recommended age of surgical repair is between four and 12 months. this age is ideal for many reasons including the size of the penis and the slow rate of growth of the penis.

Children should not be circumsiced because the foreskin if often essential in hypospadias repair surgery.

Prognosis
After hypospadias repair the penis appears normal and functions normally, very few children experience postoperative complications (woud infections, unexpected opening near the repair site)

Possible forms of hypospadias :
  1. Glandular / Distal
  2. Midle penile
  3. Pen scrotal
  4. Perinea/proximal
Sources : RSU Zainoel Abidin, Dr. Dahril SpU. Health Massenger

2 comments:

Anonymous said...

yes i have a son thats 19yrs old. and wen he was born his his located in the Scrotal. but he has had numeruis surgery's, when he was a baby. okay today he's having alot of health problems. I don't know if and what it could cause. but he run's high fever and vomiting qiuet often. he just was hospotialized for 3 weeks and they tested all of his organ's and everything came out neg. so what i was wondering was are could it cause any serious health problem's. ohhh yea when they did explorial surgery, the stomach dr. did say that he had sprung another leak in the same place. and i notice when i stayed with him in the hospital that it takes like almost 5 minutes before he could empty his blatter. and he's always having to urinate it seem's like every 10 are 15 minutes all day long. so if there is anything that u could figure out then let me know.. thanks.

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