outcome of pediatric hypospadias

7/25/2019 Outcome of Pediatric Hypospadias

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Outcome of PediatricHypospadias

Repair in Adulthood

dr. Johanes R.M Marpaungdr. Suwardi Sp.B, Sp.BA

Open Access Journal of Urology

28 April 200

Boris !her"in,#an $ra",Ofer % Shenfeld2


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Introduction

&ypospadias 'ay (e de)ned as a *en"ralpenile hypoplasia wi"h so'e associa"edano'alies such as "he following+ opening of

"he 'ea"us (elow "he "ip of "he penis, *en"ralpenile cur*a"ure chordee- and a hoodedforesin wi"h e/cessi*e dorsal par".

he incidence of hypospadias in "he 1es"ern

coun"ries has (een in rise "re'endously andis appro/i'a"ely "o 0,300 'ale (ir"hs

Mouri4uand $#5, $ersad R, Shar'a S.


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Journal of $edia"ric Urology 203-6, 007 09


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Hypospadias surgical procedure ischaracterized by three steps+

. !orrec"ion of chordee : s"raigh"ening of "he penis;

2. Ure"hroplas"y : recons"ruc"ion of "he 'issing par"

of "he ure"hra;3. Res"ora"ion of "he "issues for'ing "he *en"ral

radius of "he penis : "he glans, corpus spongiosu',

and sin, which )nally will lead "o "he nor'alcos'e"ic appearance of "he penis.

!her"in B,


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Methods

All surgical "echni4ue forhypospadias repair 'ay (e di*idedin"o four groups

. Ure"hral Ad*ance'en"

2. Ure"hral u(ulari>a"ion

3. ?asculari>ed =laps

@. raf"


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Urethral Advancement he "echni4uesfor ad*ancing "he ure"hra refer "o

processes of adus"ing "he dis"al e/"re'i"yof "he penis, used in repairing an"eriorfor's of hypospadias, wi"hou" associa"edchordee.

Urethral Tubularization he generalprinciple of "hese "echni4ues is, as "heir

na'e indica"es, "o use "he ure"hral pla"e,which, once preser*ed, can (e "u(ulari>edupon i"self as far as "he "ip of "he glans.



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The vascularized faps consis" of "he

crea"ion of a new ure"hral "u(e using*arious Caps of sin "aen direc"lyfro' "he penis

Grats Dn "he las" group are "hosechildren in who' "he prepu"ial'ucosa is insuEcien", "he use a freegraf" of (uccal 'ucosa



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Recen"ly a !anadian group20 pu(lished "heire/perience wi"h "he long "er' followup af"erhypospadias repair wi"h special e'phasis onurinary sy'p"o's in adul"hood.

hey e*alua"ed pa"ien"s who underwen"diFeren" "ypes of hypospadias repair.

Only 28 pa"ien"s answered on "he 'ailed4ues"ionnaire.

he a*erage age of responden"s was 20years.

2G of su(ec"s repor"ed diEcul"y s"ar"ing"heir s"rea's when *oiding

*an der 1erF J=A, Boe*e 5, BrusH !A, *an der Meulen J!


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Sexual function in adults who ha!epre!iously undergone hypospadiasrepairs

As "he child grows in"o adul"hood, se/ual func"ion(eco'es an i'por"an" issue

Se/ual dysfunc"ion in adul"s "ha" ha*e undergonehypospadias surgery 'ay "ae on 'any for'sincluding (ody i'age issues due "o a his"ory ofgeni"al surgery, and geni"al scaring, residual orrecurren" penile cur*a"ure possi(ly causing (o"hcos'e"ic and func"ional diEcul"ies, erec"iledysfunc"ion and eacula"ory pro(le's.



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Results"

he "echni4ues for hypospadias repairha*e e*ol*ed o*er "he years. he 'os"popular "echni4ue now is "u(ulari>edincised pla"e ure"hroplas"y. ong"er'resul"s wi"h "he use of "he new"echni4ues of "he hypospadias repair in

"er's of *oiding and se/ual pro(le'sshould (e addressed.



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#onclusion

here is a need for *alid s"udies on "heou"co'es of hypospadias repair inadul"s "ha" were perfor'ed inchildhood in "er's of cos'e"icappearance, *oiding and se/ualperfor'ance.


Boris !her"in, #an $ra",Ofer % Shenfeld2

outcome of pediatric hypospadias

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