All are TRUE about hypospadias, EXCEPT ?
Correct Answer: Avoid surgery till pubey
Description: Ans. is 'b i.e. Avoid surgery till pubey Different books mention different age criteria for correcting hypospadias. Campbell's urology states "Best time for surgery for hypospadias is between 6-12 months of age." Hypospadias: This is a condition in which the external meatus of the urethra is situated at some point on the undersurface of the penis or perineum. Besides the abnormal position of external urethral meatus the other associated abnormalities are a) In the penile variety the urethra and corpus spongiosum distal to the ectopic opening are absent, Instead a fibrous cord is present. Due to contracture of this fibrous cord, the penis is curved ventrally (in a downward direction) this is known as chordee. So the more proximal the ectopic opening is placed the greater is the chance of chordee. This curved penis causes problem in intercourse as well as micturition. b) In all cases, inferior aspect of the prepuce is poorly developed. While the superior aspect is normally developed. This causes prepuce to take the form of hood and is called hooded prepuce. Complications of hypospadias ? a) Difficulty in directing the urinary stream. b) Due to presence of chordee, erection is difficult and painful and the intercourse may be difficult or impossible. c) Infeility can occur (usually associated with posterior type), T/T of Hypospadias: T/T of hypospadias is very complex. Here are some impoant points. Treatment is not required in anterior variety. In this variety the patient is usually functional both for micturition and procreation and repair is done primarily for cosmetic reasons. In case of other varieties, a plastic operation is performed to bring the external urethral meatus to its normal position, and remove the chordee to straighten the curvature. Operation can be done in one stage or two stage surgeries. Now days one stage surgeries are more popular. - Indication for 2 stage operation - Scrotal or perineal variety - Even sever proximal types have been treated in single stage repair with success. - Circumcision is not done in patients with hypospadias as the prepuce can later be used in surgical repair.
Category:
Surgery
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