Hypospadias is a common congenital abnormality of the penis where the urethral meatus is located on the ventral side of the penis. It occurs in about 1 in 125 births. Genetics and disrupted hormone signaling during fetal development are contributing factors. Classification is based on the location of the urethral opening. Treatment involves surgical correction, usually between ages 3-18 months, to relocate the urethra and reconstruct the foreskin using techniques like tubularized incised plate repair. Complications can include fistulas or strictures requiring further surgery.

1. OLEH :
DR. DONI PERMANA PUTRA
PEMBIMBING :
DR. M. IKHSAN, M.KED, KLIN., SP
.BP-RE

2. DEFENISI
 Hipospadia adalah kelainan kongenital paling umum pada penis. Kondisi ini
ditandai dengan Meatus Uretra Eksterna yang secara ektopik terletak di proksimal
lokasi normal dan berada pada aspek ventral penis.
Leung AKC, Robson WLM. Hypospadias: An update. Asian J Androl. 2007;9(1):16–22.
2

3. EPIDEMIOLOGI
 Hipospadia merupakan salah satu cacat lahir yang paling umum ditemukan.
 Angka kejadian hipospadia mencapai 1:125.
 Ras kulit putih non-hispanik > ras-etnis lain.
 Prevalensi tertinggi terjadi di Amerika Utara, 34,2% per 10.000 kelahiran dan terendah di
Asia, yaitu 0,6% – 0,9% per 10.000 kelahiran
3
Carmichael SL, Shaw GM, Nelson V, Selvin S. 2003. Hypospadias in California: Trends and descriptive epidemiology. Epidemiology.
Bergman JEH, Loane M, Vrijheid M, et al.2015. Epidemiology of hypospadias in Europe: a registry-based study.

4. ETIOPATOFISIOLOGI
 Genetik
Persentase kejadian mencapai 7%
Hipospadia dapat diturunkan melalui sisi ibu dan ayah
 Metabolisme Androgen
Cacat genetik pada jalur metabolisme androgen (yaitu defek reduktase 5-alfa-II
atau defek reseptor androgen) diketahui menyebabkan hipospadia.
4
van der Zanden LFM, van Rooij IALM, Feitz WFJ, Franke B, Knoers NVAM. 2012. Aetiology of hypospadias: A systematic review of genes and environment. Hum Reprod Update.

5. ETIOPATOFISIOLOGI
 Sinyal Seluler Abnormal
Hipotesis alternatif yang diusulkan tentang mekanisme hipospadia terjadi
karena sinyal seluler abnormal selama masa embrional.
 Disrupsi Endokrin
Zat dengan aktivitas estrogenik yang diketahui seperti insektisida yang
digunakan dalam produksi tanaman, estrogen tumbuhan alami, produk
sampingan dari produksi plastik dan obat-obatan.
5
Baskkin LS. 2000. Pediatric. Hypospadias. Anatomy, Embryology, And Reconstructive Techniques. J Chem Inf Model.

6. KLASIFIKASI
6
Widomska Justyna AB. 2017. The Genetic and Environmental Factors Underlying Hypospadias. Physiol Behav.

7. KLASIFIKASI
7
Nelligan. 2018. Plastic Surgery. Craniofacial, Head and Neck Surgery. London, New York. Elsevier Inc.

8. DIAGNOSA BANDING
 Epispadia
 Fissura Uretrocutaneous
 Disorder of Sex Development
8
Nelligan. 2018. Plastic Surgery. Craniofacial, Head and Neck Surgery. London, New York. Elsevier Inc.

9. PENATALAKSANAAN
9
Nelligan. 2018. Plastic Surgery. Craniofacial, Head and Neck Surgery. London, New York. Elsevier Inc.
Tindakan Operatif
 Mengembalikan fungsi sefisiologis mungkin
 Waktu operasi terbaik pada usia : 3-18 bulan

10. PENATALAKSANAAN
10
Teknik Operasi
 Penoscrotal Transposition
Nelligan. 2018. Plastic Surgery. Craniofacial, Head and Neck Surgery. London, New York. Elsevier Inc.

11. PENATALAKSANAAN
11
Teknik Operasi
 Tubularized incised plate repair
Nelligan. 2018. Plastic Surgery. Craniofacial, Head and Neck Surgery. London, New York. Elsevier Inc.

12. PENATALAKSANAAN
12
Teknik Operasi
 Meatoplasty and glanuloplasty
Nelligan. 2018. Plastic Surgery. Craniofacial, Head and Neck Surgery. London, New York. Elsevier Inc.

13. PENATALAKSANAAN
13
Teknik Operasi
 Onlay island flap repair
Nelligan. 2018. Plastic Surgery. Craniofacial, Head and Neck Surgery. London, New York. Elsevier Inc.

14. PENATALAKSANAAN
14
Warren T. Snodgrass M. 2020. Hypospadias. Pediatr Rev Vol25
First Stage Hypospadias Repair

15. PENATALAKSANAAN
15
Second Stage Hypospadias Repair
Nelligan. 2018. Plastic Surgery. Craniofacial, Head and Neck Surgery. London, New York. Elsevier Inc.

16. PENATALAKSANAAN
16
Two Stage Hypospadias Repair
Nelligan. 2018. Plastic Surgery. Craniofacial, Head and Neck Surgery. London, New York. Elsevier Inc.

17. KOMPLIKASI
 Urethrocutaneous fistula
 Meatal stenosis
 Urethral stenosis
 Glans dehiscence
 Urethral diverticulum or urethrocele, which can lead to infections and post-void dribbling
 Cosmetic issues: Excess residual skin, skin tags, inclusion cysts, skin bridges, suture tracts
 Hair-bearing urethra
 Recurrent or persistent penile curvature
 Spraying or misdirected urinary stream and/or irritative symptoms
 Erectile dysfunction
 Balanitis xerotica obliterans of the urethra leading to strictures
17
Melise A.K, Sumit D. Current hypospadias management: Diagnosis, surgical management, and long-term patient-centred outcomes. Division of Urology, Department of Surgery, University of Ottawa, Canada

18. DAFTAR PUSTAKA
 Leung AKC, Robson WLM. Hypospadias: An update. Asian J Androl. 2007;9(1):16–22.
 Van der Zanden LFM, van Rooij IALM, Feitz WFJ, Franke B, Knoers NVAM, Roeleveld N. Aetiology of hypospadias: A systematic
review of genes and environment. Hum Reprod Update. 2012;18(3):260–83.
 BASKIN LS, Pediatric. HYPOSPADIAS. ANATOMY, EMBRYOLOGY, AND RECONSTRUCTIVE TECHNIQUES. J Chem Inf Model.
2000;53(9).
 Carmichael SL, Shaw GM, Nelson V, Selvin S, Torfs CP, Curry CJ. Hypospadias in California: Trends and descriptive epidemiology.
Epidemiology. 2003;14(6):701–6.
 Bergman JEH, Loane M, Vrijheid M, Pierini A, Nijman RJM, Addor MC, et al. Epidemiology of hypospadias in Europe: a registry-based
study. 2015;33(12):2159–67.
 Widomska Justyna AB. The Genetic and Environmental Factors Underlying Hypospadias. Physiol Behav. 2017;176(5):139–48.
 Nelligan. 2018. Plastic Surgery. Craniofacial, Head and Neck Surgery. London, New York. Elsevier Inc.
 Melise A.K, Sumit D. Current hypospadias management: Diagnosis, surgical management, and long-term patient-centred outcomes.
Division of Urology, Department of Surgery, Children’s Hospital of Eastern Ontario, University of Ottawa, Ottawa, ON, Canada.
18