While cosmesis and sexual function are the initial concerns, genitourinary complications may arise and warrant pediatric urologic consultation. The urethra is a tube connecting the bladder to the tip of the penis, carrying urine wee outside of the body. Hypospadias and epispadias definition of hypospadias and. Major nursing care plan objectives for the child with hypospadias or epispadias include improving the childs physical appearance, ensuring a positive body image, providing relief of pain and discomfort, decreasing parental anxiety, and absence of complications bleeding, infection, catheter obstruction and sexual. It is more common in some families and in premature. In medicinelangen terms the difference between epispadias and hypospadias is that epispadias is medicine a deformity in which the urethra opens upon the top of the penis, instead of at its extremity while hypospadias is medicine a birth defect of the male urethra that involves an abnormally placed urinary meatus. Hypospadias specialty center specializes in epispadias repair. The extra tissue of the foreskin may be needed to repair the hypospadias during surgery. Hypospadias is a urogenital birth defect in which the urethral opening is located more proximal than its usual location at the tip of the glans. The exstrophy epispadias complex comprises a spectrum of congenital abnormalities that includes classic bladder exstrophy, epispadias, cloacal exstrophy, and several variants. The aim of this study was to evaluate the frequency of urinary tract infections uti in boys with hypospadias pre peri and postoperatively in order to determine whether antibiotic prophylaxis for uti is warranted when they undergo a reconstructive surgery for hypospadias. The urethral opening can be anywhere from the tip of the penis to the scrotum and sometimes as far back as the anus. Hypospadias and epispadias are congenital defects of the urinary tract.
The urethral opening may be located as far down as in the scrotum or perineum. Hypospadias surgery, an illustrated guide 2004, springer verlag. Hypospadias and epispadias definition hypospadias is a congenital defect, primarily of males, in which the urethra opens on the underside ventrum of the penis. Hypospadias is a birth defect of the urethra where the tube stops short of the tip of the penis. When hypospadias occurs, the end of this tube does not form properly and the urine can come out.
Hypospadias can be defined as hypoplasia of the tissues forming the ventral aspect of the penis beyond. The main symptom of epispadias is the shape of the urethra which gets abnormal and becomes much shorter and wide. In most cases, hypospadias is repaired between 6 and 18 months of age. Jun 16, 2019 hypospadias is an abnormality of anterior urethral and penile development in which the urethral opening is ectopically located on the ventral aspect of the penis proximal to the tip of the glans penis, which, in this condition, is splayed open.
In boys with epispadias, the urethra opens in top of the penis rather than the tip. In epispadias, the opening of the urethra is either on the top of the urethra or on the sides of it. Hypospadias is a congenital abnormality of the penis that is characterized by an abnormal position of the urethral opening. As in most surgery, especially for small children, hypospadias should be repaired by a specialist who does many repairs. Hypospadias epispadias is often associated with other anomalies like bladder extrophy. Urethral opening appears on underside of penile shaft or on the perineum. It affects about one in 150 male babies, and is usually detected at birth. Epispadias is a rare malformation of the penis in which the urethra ends in an opening on the upper aspect the dorsum of the penis. The exstrophy epispadias complex eec is the most serious form of abdominal midline malformation. Hypospadias refers to a birth defect of the male urethra. The advice and observations suggested for followup care are the same. Hypospadias is a condition in which the opening of the urethra is on the underside of the penis instead of at the tip.
Learn and reinforce your understanding of hypospadias and epispadias through video. We recommend surgery during this age range because your babys heart and lungs have matured and his penis is a good size for surgery. Hypospadias hypospaydius is an abnormality of the penis. Hypospadias is defined as an insufficient development of the urethral fold and the ventral foreskin, with or without penile curvature. Epispadias and hypospadias american urological association. As with hypospadias repair, a urethral catheter and dressing are left in place after surgery. Hypospadias may cause a curvature of the penis, called chordee. Hypospadias is a birth defect in boys in which the opening of the urethra is not located at the tip of the penis. The characteristic defects of the eec involve the urinary system, the musculoskeletal system, the pelvis, the pelvic floor, the abdominal wall, the genitalia and sometimes the.
Congenital absence of upper wall of urethra that results in a urethral meatus on the dorsum of the penis. Feb 21, 2019 exstrophy epispadias syndrome is a complex anomaly that often requires several surgical procedures and requires lifelong medical followup care. It is a book that should be available in all paediatric urological departments since it will help the paediatric urologist to develop an optimal approach to the different forms of hypospadias. Epispadias is a congenital anomaly of the urethra and the genital tubercle which belongs to the exstrophy epispadias complex eec. During the first 2 months of gestation, the embryo germinal disc is subjected to a complex process delimitation 1 of craniocaudal tubularization resulting in the cavitation and connection of the pelvic.
The incidence of hypospadias has increased during the last decades, and it is hypothesized that endocrine disruptors might be partially responsible 15. The location of the opening can vary and can be anywhere from underneath the tip of the penis more common to the base of the penis less common. Bladder exstrophy and epispadias great ormond street hospital. With hypospadias, the opening of the urethra may be located anywhere along the underside of the penis. In boys, the urethra may be very short and split, and as a result it emerges on the top surface of the penis rather than in its usual position at the end of the penis. The child rarely has to spend a night in the hospital. Usually the foreskin is lacking in front of the penis. The space between this opening and tip of the penis appears like an open book gutter. Hypospadias repair is done most often when boys are between 6 months and 2 years old. Surgery should be only done by an experienced paediatric urologist. However, treatment usually involves surgery to reposition the urethral opening and, if necessary, straighten the shaft of the penis.
Here are four 4 nursing care plans ncp for hypospadias and epispadias. It is the secondmost common birth abnormality of the male reproductive system, affecting about one of every 250 males at birth. Bladder exstrophy and epispadias great ormond street. In girls with epispadias, the urethral opening is towards the clitoris or. When it is present closer to the junction of the penis and the scrotum, it is called a proximal hypospadias. Surgery is usually done between the ages of 6 and 12 months. Where the opening is along the shaft of the penis determines how severe the condition is.
Within the 1st year of life no circumcision before. Assisted reproductive technology and major structural birth defects in the united states. There is no alternative to surgery to correct the opening or the curvature of the penis. The abnormal opening can form anywhere from just below the end of the penis to the scrotum. Etiology and management of hypospadias and epispadias. It occurs when the bladder does not fold and close and therefore the abdominal wall and the pelvic bones cannot close over the bladder. The opening can form on the undersurface of the penile shaft in any position from the tip of the penis to the scrotum see figure 1. All boys with bladder exstrophy also have epispadias, but it can occur on its own.
The goal of surgical correction is to create a penis with. For glanular hypospadias with mobile meatus, the aut hor prefers to use the inverted y technique. Hypospadias and epispadias occur across the world and may go untreated and neglected. A penis with no hypospadias the opening is at the tip. Diagnosis is made during hypospadias or epispadias repair using an artificial erection. As nouns the difference between epispadias and hypospadias. Hypospadias is a common variation in fetal development of the penis in which the urethra does. Hypospadias is a common variation in fetal development of the penis in which the urethra does not open from its usual location in the head of the penis. If the penis looks abnormal, circumcision should not be done. Hypospadias refers to a birth defect of the male urethra where the urinary opening is not on the head of the penis, but on its inferior surface. It is one of the most common congenital abnormalities in the united states, occurring in about one of every 125 live male births. Hypospadias and epispadias are both congenital conditions involving an abnormal opening of the urethra. Learn vocabulary, terms, and more with flashcards, games, and other study tools.
Apr 10, 2019 here are four 4 nursing care plans ncp for hypospadias and epispadias. Hypospadias is a congenital cleft in the floor of the urethra, the meatusopening on the floor at some point between the scrotum and the end of theglans penis, the channel in front of the meatus being a gutter and not atube. Boys who are born with hypospadias should not be circumcised at birth. In more severe cases it lies away from the tip at the base of the penis, at the scrotum, or even behind the scrotum this is called proximal or posterior hypospadias. Hypospadias is a common penile malformation, which is usually surgically corrected in early childhood.
Pdf hypospadias is one of the most common congenital anomalies in men. Mar 29, 2018 some forms of hypospadias are very minor and do not require surgery. Hypospadias is an abnormality of the penis in which the opening of the urethra is not at the end of the penis. While male hypospadias, epispadias, and cryptorchidism are readily accessible for observation, and thus cause more parental preoccupation, female hypospadias and epispadias are also problematic. Mettauer recognised skin shortening as a cause of chordee, a fact not. This is a quite frequent congenital malformation with an overall inci dence of about 8. Presentation covering hypospadias, epispadias and bladder exstrophy, basic embryology, developmental defects, management principles, surgical techniques and as slideshare uses cookies to improve functionality and performance, and to provide you with relevant advertising. This procedure often includes straightening the penis. To understand the types and treatment of epispadias, it is essential to know the symptoms of epispadias. The meatus can be present very close to, but not at the tip of the penis this is called a distal hypospadias. Bladder exstrophy is a very rare abnormality that is present at birth congenital.
But many cases of hypospadias call for surgery to move the urethra and opening. Ucsf department of urology epispadias and exstrophy. Jun 05, 2017 presentation covering hypospadias, epispadias and bladder exstrophy, basic embryology, developmental defects, management principles, surgical techniques and as slideshare uses cookies to improve functionality and performance, and to provide you with relevant advertising. While epispadias is inherent in all cases of exstrophy it can also, much less frequently, appear in isolation as the least severe form of the complex spectrum. Hypospadias results from incomplete development of the urethra the tube that carries urine from the bladder to the tip of the penis. The location of the displaced urethral meatus may range anywhere within the glans, the shaft of penis, the scrotum, or perineum. Hypospadias is an abnormality of anterior urethral and penile development in which the urethral opening is ectopically located on the ventral aspect of the penis proximal to the tip of the glans penis, which, in this condition, is splayed open. Epispadias hypospadias repair specialists hypospadias. Unless very mild, hypospadias is usually corrected by surgery. Partial epispadias may sometimes be remedied by a plastic operation. Pdf reconstruction of hypospadias and epispadias with buccal. Hypospadias, epispadias, and cryptorchidism american. The corresponding defect in females is an opening of the.
There are different degrees of hypospadias, depending on how far away the end of the urethra is from the tip of the penis. Patient education handout hypospadias children will not outgrow hypospadias and there are no medicines to fix it. Maternal reproductive and demographic characteristics as risk factors for hypospadias. Included in the study group were 174 boys undergoing reconstructions for hypospadias. D ischarge from h ospital and m anagement at h ome. Hypospadias occurs in approximately 1 in every 250 male births in the united states.
At childrens minnesota, the experienced pediatric urology surgery team provides. Open to affected individuals, their family members, and health professionals. Hypospadiasepispadias is a urological condition corrected through surgery. The exact cause of this problem is not known in most cases. The dictum, there is nothing new in surgery not previously described, is particularly true of hypospadias. All boys with hypospadias do not require surgery, the very mild cases will not have a major impact on a childs life but some parents will still opt for surgery for cosmetic reasons. We report our experience using buccal mucosa free graft as primary surgery for hypospadias and epispadias. Each of these anomalies is thought to result from the same embryologic defect. Between the two, it is called a midpenile hypospadias. Reconstruction of hypospadias and epispadias with buccal mucosa free graft as primary surgery. In boys with hypospadias, the urethra forms abnormally during weeks 814 of pregnancy. Pdf hypospadias surgery has developed into a well defined art and science. The baby is born with the bladder and urethra open on the abdominal wall. Paediatric urology european association of urology.
Hypospadias is a congenital anomaly of the male urethra that results in abnormal ventral placement of the urethral opening. Epispadias is an uncommon condition in which the urinary opening is on the top of the penis, most often near its base. Epispadias is an uncommon and partial form of a spectrum of failures of abdominal and pelvic fusion in the first months of embryogenesis known as the exstrophy epispadias complex. In general, the frequency seems rather constant, at 0. Pdf reconstruction of hypospadias and epispadias with. Hypospadias has been repaired surgically for many years with high success. This means they occur during intrauterine development. The major significance of chordee was fully appreciated by galen in the second century a. Hypospadias and epispadias nursing care management nurseslabs. Barr, an interim note on the application of the skin biopsy test of chromosomal sex to hermaphrodites surg.
Hypospadias and epispadias nursing care management. Hypospadias is a congenital abnormality in which the urethral meatus is located on the ventral side, or undersurface of the penis. Severe types of hypospadias are corrected to promote a normal sexuality and micturition. Hypospadias, a condition where the urethra opens on the underside of the penis with associated ventral penile curvature, is the second most common genital birth. The incidence of hypospadias is reported around 1%. Epispadias is a rare congenital present at birth abnormality that involves the opening of the urethra the tube from which urine exit the bladder. Introduction hypospadias is believed to result from arrested penile development, leaving a proximal urethral meatus. Hypospadias surgery is a comprehensive and extremely wellillustrated publication on all aspects of hypospadias surgery. Hypospadias and epispadias atlas of pathophysiology, 2 edition.
A nonprofit organization founded for the education and support of people with these conditions. By the way, people with hypospadias can have difficulty with incontinence, too, although it is often more a leaking situation rather than a reduction in bladder voiding control. This means that blood relatives do not have increased chances of developing them. Lots of other conditions can cause incontinence, such as spinal cord damage or weakness of the pelvic floor muscles. Hypospadias is a congenital since birth abnormality of a boys penis. Jun 06, 2015 by the way, people with hypospadias can have difficulty with incontinence, too, although it is often more a leaking situation rather than a reduction in bladder voiding control. Hypospadias is one of the most common congenital defects affecting the external male genitalia. In the united states, epispadias repair is often done on an outpatient basis or with an overnight stay.