Hypospadias

Introduction:Hypospadias is the congenital anomaly where the urethral opening is situated on the under surface of stomach instead of at the tip of the glance. In the fetal life there is aberration in the development of the urethral tube. Therefore, the development of the urethral tube is incomplete.

Types: The hypospadias may be distal & proximal or glanular, coronal, mid penile, proximal penile, penoscrotal & scrotal according to the site of urethral meatus.

Parts: Dorsal hood is formed by incomplete prepuce, chordee i.e.ventral curvature of penis, hypospadiac meatus, urethral plate. All or some components are present in any given case.

Investigations: The diagnosis is usually clinical. The more proximal hypospadias are evaluated to rule out intersex. In this context the descent of testes is important. If both the testis are fully descended then the possibility of intersex is less but if one or both testes are undescended then the possibility of intersex should thought of.

Management: The repair of hypospadias involves correction of chordee & formation of urethral tube. This can be done in one stage or in stages. There are many types of repair, Duckett's island prepucial flap, Byer's repair, Snodgrass (TIPS) repair are few of them.