Hypospadias Treatment in Lahore

August 22, 2020 by admin0
hypospadias-treatment.jpg

What is Hypospadias?

Urethral opening proximal or ventral to the normal granular location.

Caused due to arrested penile development

Characteristics:

  • Ventral meatus
  • Ventral curvature
  • Dorsal hood of prepuce

Defects:

  • Downward glans tilt
  • Deviation of the median penile raphe
  • Ventral curvature
  • Midline scrotal cleft
  • Scrotal encroachment onto the penile shaft

If you want more information call us 03171172688 or LIVE CHAT with our experts…!

Development of Hypospadias:

Cloacal endoderm:

  • Primitive urethral plate, ventrally

Medial endoderm:

  • Male urethra, ventrally

Lateral Ectoderm:

  • Skin of penile shaft and prepuce
  • Layers fuse posteriorly to anteriorly, forming median raphe.
  • Arrest in fusion causes hypospadias
  • Abnormal development of growth plate, disproportionate corpora and fibrosis leads to penis curvature

Main Differential Diagnosis:

Characterized by asymmetrical perpetual development but normal granular meatus

Varient terms:

  • Almost 1 out of 300 males affected by this disease.
  • Risk is 13 fold in 1st degree relatives
  • 8% patients have father with hypospadias, 14% have male siblings with hypospadias.
  • Some are under hypospadias treatment

Risk Factors of Hypospadias in Next Child:

If your one child has hypospadias than the next one also affected and need hypospadias treatment.

  • 12% with negative family history
  • 19% if cousin or uncle has hypospadias
  • 26% if father or sibling has hypospadias
  • Placental dysfunction
  • Low birth weight
  • Preterm birth
  • Pre pregnancy maternal obesity
  • Extreme of maternal age
  • Assistive reproductive techniques

Hypospadias Associated with Normalies:

  • Undescended testes of 9% chances
  • Inguinal hernias 9% chances
  • Upper urinary tract anomalies
  • Utriculus masculinus is incomplete mullerian duct regression
  • Intersexuality needs to be ruled out especially in cases of non-palpable testis

Syndrome:

  • 90% are isolated penile defects. Rest are syndrome namely.
  • Smith lemli Optiz syndrome
  • WAGAR syndrome
  • Wolf Hirschorn syndrome
  • 13p deletion
  • Hand foot uterus syndrome

Types of Hypospadias:

Anterior hypospadias:

  • Granular
  • Coronal
  • Subcoronal

Middle:

  • Distal Penile
  • Mid shaft
  • Proximal penile

Posterior hypospadias:

  • Penoscrotal
  • Scrotal
  • Perineal

Diagnosis and Hypospadias Treatment:

Zaib Hospital have specialist Andrologist doctors for hypospadias treatment in Lahore.

  • Diagnosis is clinical
  • Imaging not required in cases of isolated hypospadias, regardless of severity
  • Surgery is the hypospadias treatment of choice
  • Performed at the age of 3 months or later

If you want more information call us 03171172688 or LIVE CHAT with our experts…!

Features of Hypospadias:

  • 90% hypospadias are isolated, only 10% are syndromic
  • Urinary tract imaging is not required for isolated cases
  • Surgery is the hypospadias treatment of choice to performed at the age of 3 months or older
  • Penile blocks are considered superior to caudal blocks for surgery owing together risk of penile engorgement
  • Ventral curvature at greater than 30 degree, corrected by dorsal plication
  • More than 30 degree by degloving and dissection
  • Tubularised preputial flaps have better outcomes as compared to only flaps
  • For distal repairs follow up is desired at 2 months and 8 months post operatively, while for proximal repairs, annual follow up is recommended till puberty

Risk Factors and Complications:

  • Proximal meatus
  • Re operation
  • Glans width less than 14 mm
  • Fistula
  • Glans dehiscence
  • Meatal stenosis
  • Neourethral stricture
  • Diverticulum at the flap site
  • BXO
  • Graft contractions
  • Obstructive urinary symptoms
  • Sexual dysfunction

If you want more information about hypospadias treatment call us 03171172688 or LIVE CHAT with our experts…!


Leave a Reply

Your email address will not be published. Required fields are marked *


Zaib-hospital-lahore

Zaib hospital Lahore have the modern and Chinese traditional treatment for your health. We have specialized Chinese doctors who will give you comprehensive care.

Copyright by Zaib Hospital 2016. All rights reserved.