Suggestion: This kind of situation can be treated by pediatric surgery in a local third-class first-class hospital!
I. What is hypospadias?
Hypospadias is one of the most common malformations in children's urogenital system, and about 1 newborn is sick. Generally speaking, there are three kinds of abnormalities in penis development:
1, ectopic urethral orifice: the opening is on the ventral side of penis, from the normal urethral orifice to the proximal end of perineum. The closer the urethral orifice is to scrotum or perineum, the more serious hypospadias is.
2. The penis bends downward. The closer the opening is to the glans penis, the lighter it bends, or even does not bend.
3. Abnormal distribution of foreskin: The foreskin on the ventral side of the penis head failed to fuse in the midline, and all foreskins were concentrated on the dorsal side of the penis head and piled up into a hat shape.
Note: In the case of severe hypospadias, especially scrotal fissure, chromosome examination and gonad examination must be performed before operation to confirm the sex and exclude hermaphroditism.
Second, what is the cause of hypospadias? Is it possible to suffer from hypospadias after giving birth to a second child?
1, the incidence has a certain family tendency, which may be related to many genetic factors. 2. It is related to gonadotropin deficiency. 3. In recent years, due to environmental pollution and the extensive use of chemical fertilizers and growth promoters in crops, the incidence of hypospadias is on the rise. 4. The application of pregnancy-promoting or pregnancy-protecting hormones by mothers before and during pregnancy also has an impact on the development of fetal reproductive system.
3. What are the hazards of hypospadias?
Hypospadias is often accompanied by downward bending of penis or unbearable pain when penis is erect. If it is not corrected, children with severe hypospadias need to urinate in a sitting position to avoid close contact with the opposite sex because of their fear of sexual life.
4. Is hypospadias fertile?
A person's fertility depends on the quantity and quality of sperm produced, and only a certain number of normal sperm will get pregnant and give birth. Only by examining the sperm of hypospadias patients in adulthood can we determine whether they have fertility. Here, the normal development of endocrine is the key. At present, among the patients with hypospadias admitted to our hospital, there have been cases of getting married and having children.
5. What methods are there to treat hypospadias at present? Which children need surgery?
At present, surgical treatment is the only and best treatment for hypospadias.
Except that a few urethral orifices are located in the vaginal orifice, and there is no obvious abnormality in the shape and foreskin distribution of the penis and penis head, the rest of the urethra should be treated by surgery.
6. When is the best time for surgical treatment?
The best operative age for hypospadias is 6 ~ 65438 02 months. The penis develops rapidly within 6 months, and tends to be stable after 6 months. After 6 months, the tolerance of children to anesthesia is obviously improved. In addition, the child's memory is not strong at this time, and surgery has little effect on psychological development. For example, the penis looks normal and there is no big obstacle to future sexual behavior. At this age, postoperative pain and catheter discomfort are mild, and the baby's mobility is poor, so postoperative care is easier. We also found that the incidence of complications of hypospadias plasty in older children was significantly higher than that in younger children.
Seven, so what kind of effect can be achieved after the operation?
The following criteria can be achieved after operation: 1, and the kyphosis is completely corrected. 2. The urethral orifice is located at the top of the penis head. 3, the penis looks close to normal, can stand to urinate, and can have normal sex in adulthood.
8. What problems should I pay attention to after operation?
Generally speaking, after the operation, parents are most concerned about the nursing of incision pain, wound dressing and urine drainage. Let's answer them one by one.
1, incision pain: penis is very painful after operation because of dense distribution of sensory nerves, and we all give analgesic treatment. Common methods include oral or intramuscular injection of analgesic, sedative or analgesic pump, and continuous intravenous administration for 48 hours. The effect is quite good, and there is no pain after operation.
2, wound dressing problem: We routinely use a special sponge to dress the penis after surgery, which not only plays the role of compression and hemostasis, but also does not affect the blood supply of the wound. Generally, the sponge dressing is removed 5 days after operation, and then the wound is opened until the catheter is removed. The wound does not need special treatment.
3. Urine drainage: After hypospadias plasty, we all use special urinary catheter for urethral support and urine drainage, which has the advantages of no need for cystostomy after operation, quick recovery of children after operation and convenient management and nursing. Catheters are usually removed 12~ 14 days after operation.
9. What are the most common complications after hypospadias surgery?
1, urinary fistula: that is, urine leakage during urination, which can be repaired by surgery.
2, urethral stricture: the urinary line is very thin and accompanied by dysuria. It is often necessary to remove the narrow urethra and reconstruct the urethra.
3. Infection: Infection can often cause insufficient blood supply to the reconstructed urethra, and finally lead to tissue necrosis, resulting in urethral stricture or urinary fistula.
X. Is it easy to repair children's urine leakage?
Generally speaking, the success rate of repairing urinary fistula is higher than that of urethroplasty. The reason is simple: it is more convenient to repair a point than to repair a long urethra. However, in some special cases, the repair of urinary fistula is often unsuccessful, such as the distal end of urinary fistula is narrow, the scar of urinary fistula is serious, and the long urethra is split (some doctors call it urinary fistula). In addition, it is relatively difficult to repair the urinary fistula in the coronary sulcus, and special attention should be paid to infection when repairing the urinary fistula (there are often many bacteria in the urethra at the distal end of the urinary fistula, especially the urine at the distal end of the larger urinary fistula is not washed enough). Generally speaking, the success rate of urethral surgery in specialized hospitals and specialties should be higher.
Xi。 Where can I get the most professional and best technology to treat hypospadias?
Hypospadias surgery is strictly plastic surgery. The operation precision is high, and the actual operation is difficult. Even in developed countries, there are various complications after operation. Choosing an experienced expert for the operation, usually an expert in pediatric urology, is the first step to success.