hipospadia

hipospadia
is a common congenital disease of the penis with an abnormal ventral opening of the meatus of the urethra.

Hypospadia are often associated with a ventral curvature of the penis chordee and/or a deficient ventral prepuce (foreskin) with a dorsal "hood".

Epidemiologi
18/1000 births Race

Risk factor
Family history: about 7% Further risk factors: increased maternal age, low birth weight, in-vitro fertilization.

etiologi
Embryology of the Male Urethra

Androgen Deficiency
Genetics

Manifestasi klinis
asymptomatic Distal hypospadias without curvature do not cause any functional limitations and are "only" a cosmetic problem due to the expectations of parents and patient [fig. asymptomatic hypospadia of an adult]. Proximal hypospadias can disturb the control of the urine stream; an accompanying curvature can hinder sexual intercourse.

D.D
Ambiguous Genitalia and Intersexuality Genital Anomalies

treatment
Orthoplasty
grafting of the tunica albuginea helps in straighting the penis

Urethroplasty
reconstruction of the missing distal urethra.

Neourethral coverage
Meatoplasty and glanuloplasty
Reconstruction of the meatus and the glans to achieve meatus at the tip of the penis with a vertical slit.

Skin closure : Skin coverage of the penile shaft is achieved with various techniques (e.g. transfer