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2. Hypospadias
Jabbari A

3. آشنایی با ناهنجاریهای پری ناتال و UPJO روشهای بررسی آنها روشهای درمانی
اهداف درس:
آشنایی با ناهنجاریهای پری ناتال و UPJO
روشهای بررسی آنها
روشهای درمانی
عوارض
روش ارزیابی :
تئوری بیشتر بصورت MCQ
عملی بصورت استفاده از فرمهای Logbook
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4. etiology
Hypospadias is believed to result from arrested penile development, leaving a proximal urethral meatus.
The underlying cause for nonsyndromic hypospadias in most individual cases is unknown.

5. Risk factors Placental dysfunction
Low birth weight, preterm birth, maternal obesity and diabetes, and maternal hypertension.
Maternal age (<24 years) and (>40 years)
Assisted reproduction
Paternal subfertility
Twin pregnancy.

6. Diagnosis
Hypospadias is diagnosed by physical examination, first suspected by the ventrally deficient prepuce and confirmed by the proximal meatus
Other abnormal findings include downward glans, deviation of the median penile raphe, VC, and penoscrotal transposition.

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10. ASSOCIATED ANOMALIES Cryptorchidism Prostatic Utricle
Disorders of Sex Development
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11. Timing of Surgery Best time is between 6 and 12 months
From 18 months to approximately 3 years of age has been described as a difficult period for hospitalization, leading to a recommendation that repair be postponed to age greater than 3 years
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12. Preoperative Hormonal Stimulation
Androgenic stimulation has been advocated to increase penile size, reduce VC, and improve vascularity.
Two to three intramuscular injections of testosterone enanthate 2 mg/kg over a 6- to 12- week period.
Reported mean increases in penile length range from approximately 0.5 to nearly 3 cm, with partial to complete loss of these gains by 3 to 12 months after stimulation
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13. Surgical technics TIP MAGPI Mateu Flaps: - Byars flap - Koyanagi flap
- Tubularized preputial flap
- Tunica vaginalis barrier flap
Grafts: - Preputial Grafts
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14. Thanks for your attention