APPENDIX 23 |
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HYPOSPADIASDESCRIPTION
This relatively common birth defect affects the external genitalia of both sexes, in varying degrees of severity. It occurs in males more often than females. The exact cause is not known.
IN MALES -- The urethral opening appears on the underside of the boy's penis and not at the tip; the shaft of the penis may be bent downward; the prepuce (or foreskin) may be defective or altogether absent on the underside, giving the penis a hooded appearance. In the most common form, which requires no treatment, the urethral opening will be just below the normal site. In severe cases, it may occur anywhere along the shaft, to as far back as the juncture of the penis and scrotum. In rare instances, the scrotum is divided in two with the urethral opening between the sections. About one-third of patients with hypospadias may also have other disorders of the urinary tract. If your son has hypospadias, X-ray examination of the kidneys, ureter, and bladder is in order.
IN FEMALES -- Displacement of the urethra is not so noticeable and may be discovered only in a gynecological examination. In the most severe cases, the opening may occur in the girl's vagina and manifest itself by causing difficulty in urination.
CAUSES
Possibly an abnormality of the hormonal environment prior to birth. The external genitalia (penis, vagina, clitoris, scrotum) should be carefully examined to determine the exact sex of the baby. Other studies may be needed as well. A boy should not have a circumcision if this condition is present, because the foreskin may be needed in the surgical correction of the deformity.
TREATMENT
The more severe forms of hypospadias may interfere with sexual activity in your child's adult life and have definite psychological implications for a male. The treatment is surgical, the results of which are uniformly good, though more than one operation may be required. Beginning with the first procedure at age 2, total correction can and should be completed before the child starts school.
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