Hypospadias

Definition
Hypospadias is a congenital
abnormality in the form of the urethral
opening is located next to the proximal
end of the penis. The layout of the urethral
meatus may lie in the glandular until
perineal
The urethral opening may be located as
proximal as in the scrotum or perineum.
The penis will commonly have associated
ventral shortening and curvature, called
chordee, with more proximal urethral
defects
Classification
 Epidemiology
• Occurs in hypospadias Approximately 1 in
every 250 male births in the United States.
• The incidence of hypospadias is higher in
whites than in blacks.
 Etiology and Risk Factors
The etiology of this disorder is not known
exactly (idiopathic). However, there are
several factors which is considered the
most influential:
- Genetic factors
- Factors disorders and hormonal
imbalances
- environmental factor
• Risk factor :
- Having a father with a history of
hypospadias (8%) or brother with
hypospadias (14%)
- Asissted reproduction, which relates to
hormonal manipulation
- pajana, consumption, or the high activity of
estrogen.
 Pathogenesis and
Pathophysiology
Hypospadias is a congenital defect that is thought to
occur during the embryologic development of the
urethra, between 8 and 20 weeks' gestation. The
external genital structures are identical in the males and
females until 8 weeks, after the which time the genital
structures develop a masculine phenotype in the males,
primarily under the influence of testosterone and its
byproduct dihydrotestosterone. As the phallus grows, the
open-urethral groove extends from its base to the level
of the corona.
 Signs & Symptoms
• beam when BAK is not straight, usually
downwards, spreads, or flows through the
shaft of the penis, so that children squat
when urinating.
• their chorde
• penis penis skin is thinner bottom
• prepuce is no bottom of the penis, and
accumulate the dorsal part of the penis
 Diagnosis
• anamnesis
- the chief complaint, history BAK
• Physical examination
- no skin or thin prerputium
- the position of the urethra miatus not in its proper place
- scrotum bifida
- their chorde
• Supporting investigation
- kariotyping, to determine the sex of the patient
- uteroskopi
 Management
The ideal age to do the surgery is before the
child goes to school

Stages of Operation:
- Orthoplasty
- Uretroplasty
- Glanstopasty
 Complication
• Pre-surgery • Post-surgery
- Infertility - edema
- Psychosocial - stricture
disorder - Fistula Uretrokutan
- Difficulties when - Diventrikulum
sexual berhubuhan
- Residual Chorde