Hypospadias, that is, abnormal urethral orifice, is a common congenital penile malformation in children, and the incidence rate of male newborns is about 8. In addition to affecting the normal life of children, it will also cause great psychological trauma. The cause of hypospadias is a polygenic genetic disease with a certain family tendency.
At present, there is evidence that testosterone deficiency in patients with severe hypospadias can last until adulthood. If moderate and severe hypospadias are not treated, the sexual function and behavior of patients may be affected.
Once hypospadias is diagnosed, it is necessary to choose the right time for surgical correction of penile curvature, so that the urethral orifice is as close to the normal position as possible, children can urinate upright, and adults have reproductive ability. The operation should be carried out in a large hospital specializing in pediatric urology.
2. Classification of hypospadias.
According to the position of ectopic urethral orifice, hypospadias can be divided into four types:
Penile head type: urethral orifice is located on the ventral side of penis, mostly slit-shaped.
Penile type: urethral orifice is located at any part of the ventral part of penis from the coronal sulcus to the joint between scrotum and penis.
Scrotal type: the external urethral orifice is located in the scrotum.
Perineal type: the external urethral orifice is located in perineum. Because the distal urethra of ectopic urethral orifice and its surrounding tissues are underdeveloped, fibrous cords are formed and the penis is involved. Hypospadias is often accompanied by different degrees of penile curvature.
3. The best operation opportunity for hypospadias.
Patient: When should hypospadias be treated? Is the earlier treatment, the better?
Doctor: The best operation time for hypospadias is 10- 18 months. The patient is more than 6 months old and weighs more than 10 kg. If the penis develops well, it can be operated. Patients are generally required to complete treatment before the formation of sexual psychology at the age of 3. For penile dysplasia, endocrine examination and treatment should be carried out first, and elderly patients who fail to treat should be treated as soon as possible. Patients with urethral stricture and dysuria after treatment failure should be treated again immediately.
4. Hypospadias surgery
Patient: What kind of effect can be achieved after hypospadias surgery?
Doctor: The basic method of hypospadias repair is to correct the bent penis and reconstruct the missing urethra with autologous tissue. According to the types and transfer modes of tissue transplantation in urethral reconstruction, it can be divided into mucosal and skin free transplantation and pedicled local flap transfer. Its central principle is to restore the length and shape of penis as much as possible, and flexibly use various tissue transplantation methods to reconstruct urethra.
It is the ultimate wish of plastic surgery to treat hypospadias and restore the normal shape and function of penis and urethra. The basic standards of urethral reconstruction are: the diameter of reconstructed urethra is appropriate without twists and turns; The inner wall of urethra is smooth and smooth, and there is no hair growth; The external urethral orifice is at the top of glans penis, which is longitudinally split; Urine flows linearly, without scattering and with good directionality; The reconstructed urethra has growth potential and can grow and develop with the penis. Generally speaking, regular and experienced specialized hospitals can meet the above requirements after careful preparation.
5. Does hypospadias surgery have sequelae?
Patient: What if the penis is still underdeveloped after the operation?
Doctor: After puberty, if the patient still has penile dysplasia and the penis and scrotum are displaced (that is, the penis is buried in the scrotum), local perineal plastic surgery and penis lengthening and thickening surgery should be considered. For patients with penile hypoplasia, penile reconstruction must be used to reconstruct the shape and function of penis and urethra.