What is hypospadias, causes, symptoms and treatment

It is often difficult to determine why a child with this or that pathology was born in a family. One can only advise expectant mothers: take care of your health, follow all the doctor’s recommendations. Wrong lifestyle, bad habits or non-observance of basic rules can ruin the life of your unborn child.

What is hypospadias

Hypospadias is a cumulative pathology of the penis and the urethra (urethra) without a normally formed lower wall, which entails an arbitrary location of its external opening on the anterior surface of the penis. Hypospadias is an exclusively congenital anomaly.

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It is observed mainly in male newborns. The female form of the disease is much less common.

Varieties of anomaly

Meatus in hypospadias (urethral outlet) can be located in the scrotum, coronary groove or perineum. Depending on the degree of underdevelopment of the urethra, the following forms of the disease are recorded:

  • Capitate. Metaus is located below the apex of the head of the penis.
  • Coronal is located on the coronal sulcus.
  • The stem is on the anterior surface of the penis. The lower the metaus is, the more complex the form of the disease.
  • Penis-scrotal at the junction of the scrotum and base of the penis.
  • Scrotal. The penis is severely deformed.
  • Perineal. An unformed external genital organ in this form of the disease makes it difficult to visually determine the sex of a newborn.
  • Hypospadias without hypospadias is an atypical anomaly that occurs with a shortened urethra and an underdeveloped penis. Often, false cryptorchidism, immature testicles and scrotum are simultaneously diagnosed.

The pathology is most easily tolerated in the capitate form of the disease, which is observed in three quarters of patients.

In hypospadias, curvature of the penis is often diagnosed. Its trunk can deviate in different directions from the base, in the middle or in another place. In some cases, it deforms about the longitudinal axis.

In girls, hypospadias is expressed by the displacement of the external opening of the ureter into the vagina. Underdevelopment of the urethra is accompanied by various gynecological diseases.

Reasons for the development of hypospadias in the fetus

Determining the exact cause of hypospadias is difficult. Experts identify several main factors that provoke deviations in the development of the reproductive system in the embryo:

  • Gene mutations (changes in the molecular structure of DNA)
  • The mother’s intake of steroid (male) hormones that disrupt the hormonal balance of the fetus, accompanied by deviations in the formation of the genitals.
  • Contraceptive use before pregnancy.
  • Fetal intoxication (smoking, drinking alcoholic beverages, indiscriminate medication during pregnancy, poor ecology)
  • Disorder of the endocrine system in the mother.
  • Untreated infectious diseases.
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The development of hypospadias can provoke the mother taking hormonal drugs to preserve the fetus.

The risk of this deviation increases with artificial fertilization of the egg. Sex hormones, which a woman is forced to take in such a case, negatively affect the development of the child’s genitals.

Hereditary predisposition to this pathology has been proven. Medicine knows real stories, when several generations suffered from the disease in one family.

Symptomatology of the disease

Hypospadias manifests itself quite clearly, has specific symptoms characteristic only of this disease. It is possible to make a mistake in the symptomatology in the case of a very mild form of the disease (not to notice the deviation) or, conversely, in the most severe form.

Some symptoms of hypospadias are identified on examination:

  • The exit of the urethral canal is in an uncharacteristic place.
  • Curvature of the penis.
  • An underdeveloped penis, characterized by small size and thickness.

Parents should very carefully observe the development of the newborn, tell the doctor about all their suspicions. Some symptoms are noticeable upon closer observation:

  • The stream of urine is thin and intermittent due to a narrow urethra (dysplasia) or its outlet (meatostenosis)
  • Uncharacteristic direction of the jet during urination, which leads to irritation of the skin.
  • Voluntary urination.

In the absence of proper treatment, a man can have normal intercourse only with the capitate form of the disease.

All other forms of the disease are accompanied by varying degrees of curvature of the shaft of the penis, which causes pain and discomfort during intercourse, or makes it absolutely impossible.

Diagnostics

Correct diagnosis for hypospadias and related diseases helps to assess the general condition of the child, to prescribe the correct and consistent treatment.

A specialist neonatologist will visually establish the presence of hypospadias and its shape. In the most severe cases, additional examinations are required to clarify the diagnosis and identify associated problems:

  • Palpation examination.
  • X-ray of the urethra.
  • Measurement of urine velocity.
  • Canal examination with a urethroscope.
  • Ultrasound diagnostics, specifying the location and size of the urethra. The examination shows abnormalities in the development of the genitals, bladder, kidney condition. Gives an idea of ​​the general condition of the boy.
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In some cases, the doctor advises to take a special analysis that reveals the presence of an abnormal chromosome, which is to blame for the birth of a baby with abnormalities. A thorough diagnosis guarantees the success of subsequent treatment.

Surgery is the only possible path to recovery

It is possible to eliminate such anomalies only by surgery. The operation should not be delayed. The first six months of a child’s life can be counted on for a successful result. If there are good reasons, the operation can be postponed until one and a half years of age.

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One or more operations are required depending on the complexity of the disease.

The capitate abnormality is not required. With dysplasia and meatostenosis, the urethra is expanded operatively. In difficult cases, the canal is enlarged, straightened and, with the help of plastic surgery, the structure of the penis is brought closer to the anatomical shape.

In more complex cases, the curvature of the penis is corrected in an operable way, plastic manipulations bring the urethra and the external opening to the anatomical norm.

When cryptorchidism is diagnosed, one or both testicles are surgically placed in the scrotum.

Recovery

After the operation, it is required to stay in bed under the supervision of a doctor. The urine is passed through a catheter inserted into the bladder for several weeks. It takes several months to fully recover.

After the operation, the child’s immunity should be strengthened so that the recovery process takes minimal time.

With hypospadias, you cannot hesitate, otherwise the chance for the possibility of a normal life will be missed. Timely treatment in many cases guarantees the full development of all functions of the male genital organ, eliminate problems in further intimate life.

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Tatyana Jakowenko

Editor-in-chief of the Detonic online magazine, cardiologist Yakovenko-Plahotnaya Tatyana. Author of more than 950 scientific articles, including in foreign medical journals. He has been working as a cardiologist in a clinical hospital for over 12 years. He owns modern methods of diagnosis and treatment of cardiovascular diseases and implements them in his professional activities. For example, it uses methods of resuscitation of the heart, decoding of ECG, functional tests, cyclic ergometry and knows echocardiography very well.

For 10 years, she has been an active participant in numerous medical symposia and workshops for doctors - families, therapists and cardiologists. He has many publications on a healthy lifestyle, diagnosis and treatment of heart and vascular diseases.

He regularly monitors new publications of European and American cardiology journals, writes scientific articles, prepares reports at scientific conferences and participates in European cardiology congresses.

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