Hypospadias - Causes, Symptoms and Treatment .MF .
Hypospadias - is an anomaly of the penis when the external opening of the urethra does not open at the head of the penis, and the trunk of the latter.In this case, urine stream loses its physiological direction and the patient is experiencing some difficulties during urination.
Causes of hypospadias
Hypospadias is a congenital anomaly full development, which manifests itself in children from the moment of birth.Select the sole cause of this disease is difficult, because there are many factors that can affect the normal tab fetal organs during pregnancy.
First of all, you need to identify infectious diseases, which can lead to congenital malformations.To date, proved the role of Toxoplasma and cytomegalovirus in causing developmental abnormalities.Therefore, all pregnant women should be several times during the pregnancy to be tested for the pathogens mentioned.In addition, you need to be screened for congenital syphilis and AIDS, which are also causative agents of many vices.
addition to infectious diseases, causes of congenital malformations can be a variety of physical and chemical factors.For example, pregnant women are not recommended to engage in mobile work or excessively contact with chemicals such as washing powders, detergents, varnishes, paints and others.
large number of infants with hypospadias observed in areas contaminated with radioactive substances, which allows to draw conclusions about the negative effects of radiation on fetal development.
Some medications, such as chemotherapy and anti-TB drugs can also be the cause of hypospadias in the newborn, so you must be very careful in the use of any drug during pregnancy.
Symptoms of hypospadias
only clinical sign is the presence of hypospadias meatus is not at the head of the penis, and in its trunk or on the scrotum.In principle, from where is this hole is determined by the form of hypospadias.In the most mild form of the disease, opening of the urethra is on the head, just slightly below the usual place of its location.In this case, urine flow is practically unchanged and the disease can even be noticed until puberty.
much harder disease occurs when urine stream coming out of the trunk of the penis or scrotum.There is no mucosa and constant contact with the urine to the skin, it soon occurs irritation and inflammation.If this occurs in the neonatal period, the marked deterioration in the general condition of the child.He becomes moody, he refuses the breast, gain weight poorly.Immediately identify the cause of this behavior is difficult, as the child urinates in the diaper, and parents do not see a stream of his urine.Redness of the skin in the genital area is usually perceived for diaper rash.
At older ages, the child understands his problem and even learns to urinate smoothly.Only against this background that he developed psychological complexes, which are particularly acute in adolescence when his peers become sexually active.
If there is such a problem with your child, it must immediately show the urologist to the find the right treatment strategy.
Typically, the clinical disease is enough to make the correct diagnosis and decide on treatment tactics.But it is necessary to exclude other pathology, such as urethral fistula, which may also give a similar clinical picture.For this
conducted such a study as a urethrography.The method consists of intravesical contrast agent, after which the X-rays of the pelvic held during urination.In the picture you can see the course of the urethra and place of its opening on the penis.
Ureteroscopy, which would seem to be an effective method of diagnosis of the disease is generally not used because of the high risk of damaging the wall of the urethra.
Treatment of hypospadias
only effective and justified only by surgery can be considered a correction of this pathology.The volume of transactions depends on the specific form of the disease, but in all cases the main objective of the urologist is to restore the normal shape of the urethra.
When it comes to golovochnoy form of hypospadias, where the opening of the urethra opens on the glans penis, the plastic is carried out exclusively own tissues.To do this in the correct location mucosa caves in which the urethra is derived previously mobilized from their previous place of fixation.
For more complex forms of hypospadias, where the opening of the urethra opens on the trunk of the penis or scrotum, own tissues, is usually sufficient to hold the plastic urethra effectively.In such situations, using a variety of synthetic prostheses, which are made of hypoallergenic material.
Surgical treatment of hypospadias
disease for proper formation of the urethra, in the early days after surgery patients produce staging urethral catheter to evacuate urine.The object of the patient in this case is the right care for the catheter for the purpose of urethral pressure sores prevention.The patient needs to be clarified that the receiver must be changed almost every three days, and every day to introduce antiseptic solutions in the cavity of the bladder.
Equally important is the psychological rehabilitation, as many patients develop complexes in connection with violation of sexual activity.Of particular significance it acquires in adolescents as sexual problems go almost to the fore.With these children, as a rule, psychologists, explaining to them the need to wear a temporary urinary catheter and the importance of the operation.
Antibacterial prevention of secondary infection is carried out by intravenous and intravesical solutions, antibiotics and antiseptics.For this purpose, one can furatsillin, FURAMAG or chlorhexidine, which are effective against both gram-positive and gram-negative flora.
Feeding habits and lifestyle
patients after myocardial surgery do not need special dietary food.As a rule, they consist in the total number of high-calorie table 15, which includes nutritious foods with a uniform protein, fats and carbohydrates.
As already mentioned, the particular way of life are to abstain from sexual relations, when it comes to adult patients.In order to prevent an erection, which can cause rupture of the urethral anastomosis, patients received anti-anxiety drugs on the basis of bromine.
Treatment folk remedies
Since hypospadias is exclusively surgical pathology, not to speak of the popular methods of treatment.The only thing that can advise patients is to use a lotion with chamomile solution to macerated skin of the penis and scrotum.
Complications of hypospadias
As already mentioned, the most common complication of hypospadias can be considered as skin irritation and dermatitis that occurs due to the constant contact with her urine.First, it shows a slight reddening of the skin around the opening of the urethra, and may later go into necrotizing inflammation with the formation of purulent plaque.If the treatment of the first stage of disease can be restricted by the local use of antiseptic solutions, when purulent inflammation is necessary to carry out the primary surgical treatment of wounds.Its goal is the complete removal of affected tissues, and the imposition of aseptic dressings, which prevents secondary infection.
No less important is the psychological complications of the disease.In severe forms of hypospadias often have problems when trying to urinate normally.Patients wear constantly soiled with urine.Because of the bad smell, they do not always find understanding in the team.Often this becomes a cause of deep depression, turning into acute psychosis.Literature there are cases where the cause of hypospadias became suicidal.It is worth noting that similar situations are most frequently observed in dysfunctional families, where about congenital anomaly of the children may not know until his adulthood.
Prevention hypospadias hypospadias
Prevention is a challenge, especially pregnant women, to be actively engaged in preparing for pregnancy and childbirth.First of all, it needs to pass all the tests for infection, which can lead to the development of congenital anomalies.Recall that such diseases include measles, herpes, toxoplasmosis, cytomegalovirus, syphilis and AIDS.
If a pregnant woman lives in an area with high radioactive contamination, then the period of pregnancy it is better to change their place of residence.
During pregnancy it is necessary to limit contact with all sorts of chemicals, such as paints, varnishes, detergents and cleaners.If this is not possible, it is desirable to use rubber gloves when working with these substances.
Weather favorable for life, regardless of the form of the disease.Even if you do not take any therapeutic treatments, the disease does not threaten the strong deterioration of the health of patients and the more recent death.
prognosis for recovery - relatively favorable.Despite the capabilities of modern surgery, there are forms of diseases in which even surgery may not completely remove cosmetic defect of the skin of the penis.
forecast for performance - favorable.Regardless of the form of the disease, as well as the surgery, patients with hypospadias may engage in any kind of work.
Ed.urologist, sexologist-andrologist Plotnikov AN