Hypospadia
Hypospadia is one of the most common congenital anomalies of the structure of the urethra in men. The pathology is characterized by the location of the urethral meatus (opening of the urethra) on the shaft of the penis, in the perineum or scrotum. Today, the number of patients with this pathology has increased significantly, compared to a few decades earlier. Hypospadias in newborns occurs on average with a frequency of 1:125.
Possible causes of hypospadias
The specific cause of the anomaly has not yet been definitively identified.
According to urologists, hypospadias is caused by one or more of the etiological factors listed below:
- gene mutations provoked by poor ecology;
- genetically determined predisposition;
- use of hormonal drugs by the boy's mother during pregnancy (in particular, drugs prescribed in the event of a threatened miscarriage);
- consumption by a pregnant woman of products that contain substances from the group of disruptors (destroy male sex hormones);
- use of hormonal oral contraceptives less than 12 months before fertilization of the egg.
The cases of birth of boys with hypospadias in two or more generations (burdened family history) allow us to talk about hereditary predisposition.
Disruptor substances are chemical compounds that are widely used in the processing of agricultural plants. These include various herbicides and pesticides. It has been established that these substances can lead to serious abnormalities in the development of the fetus or changes in the hormonal status of the future child.
There is reason to believe that the risk of developing hypospadias increases in children conceived through in vitro fertilization (IVF procedures). This is due to the fact that during IVF, the expectant mother is prescribed estrogen drugs for the normal course of pregnancy.
Factors that can cause abnormalities include strong psycho-emotional stress experienced by a woman during pregnancy, lack of protein in the diet. The development of the fetus is negatively affected by the mother's intake of certain drugs, smoking and consumption of beverages containing ethanol.
Clinical signs and types of pathology
Characteristic clinical signs of penile hypospadias are:
- meat displacement;
- change in the shape of the foreskin (split with the formation of a hanging area is often recorded);
- curvature of the cavernous bodies of the penis.
According to the classification accepted in clinical medicine, several types of anomalies are distinguished:
- front (coronal and cephalic hypospadias);
- average (stem hypospadias);
- posterior (perineal or scrotal);
- "hypospadia without hypospadias" (defect in the form of a chord).
In cephalic hypospadias, the meatus moves to the coronal groove. The degree of curvature of the cavernous bodies is moderate, but an abnormal shape of the foreskin is revealed.
For the coronal type of pathology, the opening of the urethral opening in the coronal furrow and the shift of the foreskin are characteristic.
The trunk form of hypospadias is characterized by the location of the meatus on the trunk of the penis. With this variety, a significant change in the shape of the cavernous bodies relative to the anatomical norm is diagnosed.
In scrotal hypospadias, the genitals are similar to female genitalia, and the meatus is located in the scrotal area. The penis is usually bent, its incorrect location is often found. The patient needs to be examined by a geneticist in order to find out the "true sex".
In perineal hypospadias, the scrotum is split, and the shape of the cavernous bodies is strongly altered relative to the anatomical norm. The external opening of the urethra opens in the perineum, and the structure of the genitals has features characteristic of both female and male genitalia.
With a defect in the form of a chord, the anatomical position of the meatus corresponds to the norm, but the urethra is underdeveloped, and connective tissue strands are often present along it.
Treatment of hypospadias in newborns and children
The elimination of the anomaly is carried out with the help of radical surgical intervention. If hypospadias is diagnosed, the operation must be performed at an early age (from 6 months to 3-4 years). The earlier operative treatment is carried out, the less likely the child will retain negative memories that can lead to psychological problems.
The main tasks of the surgeon are plastic surgery of the corpora cavernosa to correct their shape, reconstruction of the urethra and elimination of cosmetic defects.
You can make an appointment and learn more about operations for hypospadias on our website: https://dobrobut.com/.
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