Hypospadias is a congenital anomaly where the urethral opening is on the ventral side of the penis, not at the tip. It occurs in about 2-8 per 1000 male births. Causes may include low testosterone levels during fetal development. Symptoms include an abnormal urinary stream and curvature of the penis. Diagnosis involves physical exam and imaging tests. Treatment is usually surgery to reposition the urethral opening, which may require postoperative care and has risks of complications like fistulas or scar tissue formation.

1. Ratheesh.R
SLMGNC

2. Introduction:
 Hypospadiasis is a congenital anomaly of
the male urethra that results in abnormal
ventral placement of the urethral opening.
The location of the displaced urethral
meatus may range anywhere within the
glans, the shaft of penis, the scrotum, or
perineum

3. Definition:
 It is a congenital condition in
which the Urethral Meatus opens
on the ventral side of the Penis.
 Incidence – 2-8/1000
 Occurance – More common in male than in
girls.

4. Etiology:
 Down ward penis (Chordee)
 Undescended testicle
 Inguinal hernia
 Male siblings

5. Pathophysiology:
 Due to any factor
 Decreased testosterone production in early
gestation
(Male) (Female)
Urethra opens on the ventral Urethra
opens into
aspects of the penis the vagina
(rare).

6. Clinical Manifestation:
 A downward urinary spray (in this may mean
he has to sit down to urinate)
 A downward curve of the penis, called
“chordee”
 A “hooded” appearance to the penis, caused
by extra foreskin along the top side
 An abnormal appearance of the tip of the penis
(the glans)
 Inability to void urine with the penis in the
elevated position.
 In female, Urine dribbling from vagina.

7. Diagnostic Findings:
 History Collection
 Physical Examination
 Renal Ultrasound/Cystourethrography
-It is done to determine associated defects
with
Hypospadiasis.
 Chromosomal and Hormonal Studies.

8. Treatment:
Surgery:
 To reposition the opening of urethra at the tip
of the penis (urethroplasty)
 To straighten the penis, if chordee is present
(orthoplasty)
 To improve the outward appearance of the
penis (removing the hooded foreskin)

9. Cont….
After surgery:
 Depending on the extent of surgery, the child
may either go home the same day or stay in the
hospital overnight.
 The Children's nurses will talk with, how to care
for him at home and will provide detailed
instruction sheets (how to manage his dressing,
what activities should be avoided, etc.)

10. Cont….
For the child's recovery period, the doctor may
prescribe any or all of the following:
 Acetaminophen (Tylenol), to help ward off
soreness in the first few days after surgery
 Antibiotic ointment, to be applied to the penis
several times a day
 Oral antibiotics
 Antispasmodic medication, to alleviate bladder
spasms

11. Nursing Diagnosis:
 Pain r/t surgical incision and drainage tube.
 Risk for infection r/t surgical incision and
drainage tube.
 Body image disturbance r/t Appearance of
genitalia.
 Impaired urinary elimination r/t the condition
and surgical intervention.
 Risk for fluid volume deficit r/t surgical losses.

12. Complication:
 Urethral fistula (5-15%)
 Scar narrowing of the urethra (stricture)
 Recurrence of penile curvature by growth in
size of the penis with incomplete
chordeectomy.
 Urethral stenosis.
 Urethral diverticula.
 Scar deformation.
 Reproductive inability.