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Hypospadias and epispadias (Clinical presentation (Ventral/dorsal …
Hypospadias and
epispadias
Clinical presentation
Ventral/dorsal
urethral meatus
Ventral curvature of shaft
(chordee) (hypospadia)
Hooded foreskin
(hypospadia)
Diagnosis
Examination
Genital exam
Ventral/dorsal meatus, chordee, hooded foreskin
History
PMH
Known medical conditions
Previous surgery
DH
Meds, allergies
PC/HPC
Abnormal penile appearance
SH
Living arrangements, school/nursery
Management
Conservative
Information, advice, support
Watch and wait (mild forms)
Surgical
Indication: severe, cosmesis
MOA: repair to allow urination in straight line;
must not be circumcised beforehand (need tissue for reconstruction)
SEs: breakdown of repair, meatal stricture
Definition
Congenital malformation
of the urethra in boys
Epidemiology
Hypospadias common (1/200)
Pathophysiology
Hypospadia
Urethral meatus located on ventral aspect
of the penis
Failed development of ventral tissues
Epispadia
Urethral meatus on dorsal aspect
Failed development of dorsal tissues