HYPOSPADIAS
DEFINITION
It is the most common congenital malformation of urethra wherein external meatus is situated proximal than normal, over the ventral (under) aspect of the penis.
3. HYPOSPADIAS
DEFINITION
• It is the most
common
congenital
malformationof
urethra wherein
external meatus
is situated
proximal than
normal, over the
ventral (under)
aspect of the
penis.
CLASSIFICATION™
• Glandular: Meatal opening
in glans.It is the most
commontype ™
Coronal ™
Penile™
• Penoscrotal ™
Perineal with
split scrotum. This is
associatedwith bilateral
undescended testes
4. CLINICALFEATURES
• Absence of urethra and
corpus spongiosumdistal
to abnormal urethral
orifice.
• Bowing or bending of
penis distal to abnormal
urethral opening
(chordee), with poorly
developed prepuce over
inferior aspect.
• Urine soakage over the
scrotumwithdermatitis
and infection.
• Associatedcongenital
anomalies are knownto
exist.
• Karyotyping is neededto
rule out associated
intersex anomaly
5. TREATMENT
• At the age of one and half
years, surgical correctionof
the chordee is done.
• At the age of 5–7 years,
reconstructionof urethra is
doneusing prepucial skin
(ideal) or scrotal skin if the
patient has been
circumcised. Best is
prepucial skin.
• Perineal urethrostomy is
done for diversion.
• Perineal urethrostomy
should be there until
reconstructionof urethra
takes up well (Denis-Browne
procedure).
6. • MAgPI repair: Meatal
advancement glandular
repair—for glandular
hypospadias. In
hypospadias, circumcision
is contraindicatedas
prepucialskin is required
for future urethroplasty.
REFERENCE
1. SRB's Manual of Surgery
by SriramBhat M
2. A Manual on Clinical
Surgeryby Das
3. A Concise textbookof
Surgeryby Das