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Hypospadias ppt

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sheena bhatia

Hypospadias is a congenital anomaly where the urethral opening is on the underside of the penis. It is caused by arrested development of the urethra in fetal life and can be due to genetic or hormonal factors. The condition is classified based on the location of the urethral opening and may cause abnormal urination or fertility issues. Surgery is needed to correct the anomaly by repositioning the urethral opening, and pre- and post-operative nursing care and parental guidance are important for proper recovery. A study found that providing pre-operative instructions to mothers resulted in fewer complications and better cosmetic and functional outcomes for children after hypospadias surgery.

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HYPOSPADIAS PREPARED BY SHEENA BHATIA ASSISTANT PROFESSOR
HYPOSPADIAS
DEFINITION Hypospadias is the most common congenital anomaly of the penis. In this anomaly the urethral opening is situated on the ventral side of the shaft of penis in one or several positions, just behind the glans.
CLASSIFICATION BASED ON MEATAL OPENING
Hypospadias ppt
ETIOLOGY Unknown Arrested development in fetal life. Familial factor Gene mutation Lack of hormone production during fetal life due to endocrinopathies
PATHOPHYSIOLOGY Due to incomplete fusion of urethral folds along the midline Severity of condition depends on the location of opening The presence of opening near glans is known as Glandular Hypospadias Presence of opening at corona is known as Coronal Hypospadias.
CONT. Presence of opening at shaft is known as Penile Hypospadias. Opening at junction of penis and scrotum is known as Penoscrotal Hypospadias Presence of opening at perineum is known as Perineal Hypospadias
SYMPTOMS Abnormal urine stream Sexual Dysfunction later in life. Fertility Problems Psychological problems may arise.
ASSESSMENT Abnormal pattern of voiding. Stream of urine may be deflected downward. Child voids in sitting position in penoscrotal and perineal Hypospadias. In Glandular or coronal hypospadias child able to voids in standing position, by tilting the penis slightly upward
MANAGEMENT There is no medical management for this defect. Surgery may be recommended for its correction and the goals of surgery are:- To bring the urethral opening to the tip of the penis via a procedure known as Urethroplasty. To straighten the penis. Circumssion of the foreskin should be avoided as this foreskin should be used for surgical repair. Surgery should be done preferably at the age of 6 -24 months of age.
NURSING MANAGEMENT PREOPERATIVE CARE Preparing parents for child surgery. Psychological support should be given to the parents
POST OPERATIVE CARE Monitor vital signs Catheter care should be given Put restraints so that child should not take out catheter or other tubings. Urine examination should be done to rule out any infection. Support and guidance of parents is very important.
NURSING RESEARCH Background: Hypospadias is the most common birth defect among children affecting the penis characterized by ventral position of urethral meatus in which caused by arrest of normal development of the urethra. Aim of the Study: To evaluate the effect of pre- operative instructions for mothers on selected post- operative outcomes among their children with hypospadias.
Subjects and Methods: A quasi-experimental research design (pre-post test) was used to achieve the aim of the current study. A convenient sample of 60 mothers having male children undergoing surgical repair of hypospadias participated in the current study, divided into two equal groups: 30 as a control group and 30 as a study group who were subject to the preoperative instructions. The setting was in-patient Pediatric Surgical Department at Cairo University Specialized Pediatric Hospital (CUSPH). The required data was collected through: 1- Structured interview (questionnaire); 2- Mothers' knowledge and reported practice assessment sheet (pre-post test) and 3- Post-operative outcomes assessment record.
CONT Results: The study's results revealed that, children in the study group exposed to less early post-operative complications such as (bleeding, wound dehiscence, urinary obstruction and urinary catheter fall) than children in the control group. Late post-operative complications (fistula, meatal stenosis, urethral obstruction and infection) occurred in children in the study group less than those in the control group. Children in the study group had appropriate cosmetic appearance of the penis and functional outcome than children in the control group. Conclusion: The current study concluded that children whom mothers received the pre-operative instructions about hypospadias had improved outcomes in relation to less complications, higher cosmetic and functional outcomes than children in the control group.
Recommendation: It was recommended that provision of pre and post-operative care of children undergoing hypospadias repair is mandatory to achieve satisfactory post-operative outcomes.
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Hypospadias ppt

  • 3. DEFINITION Hypospadias is the most common congenital anomaly of the penis. In this anomaly the urethral opening is situated on the ventral side of the shaft of penis in one or several positions, just behind the glans.
  • 4. CLASSIFICATION BASED ON MEATAL OPENING
  • 6. ETIOLOGY Unknown Arrested development in fetal life. Familial factor Gene mutation Lack of hormone production during fetal life due to endocrinopathies
  • 7. PATHOPHYSIOLOGY Due to incomplete fusion of urethral folds along the midline Severity of condition depends on the location of opening The presence of opening near glans is known as Glandular Hypospadias Presence of opening at corona is known as Coronal Hypospadias.
  • 8. CONT. Presence of opening at shaft is known as Penile Hypospadias. Opening at junction of penis and scrotum is known as Penoscrotal Hypospadias Presence of opening at perineum is known as Perineal Hypospadias
  • 9. SYMPTOMS Abnormal urine stream Sexual Dysfunction later in life. Fertility Problems Psychological problems may arise.
  • 10. ASSESSMENT Abnormal pattern of voiding. Stream of urine may be deflected downward. Child voids in sitting position in penoscrotal and perineal Hypospadias. In Glandular or coronal hypospadias child able to voids in standing position, by tilting the penis slightly upward
  • 11. MANAGEMENT There is no medical management for this defect. Surgery may be recommended for its correction and the goals of surgery are:- To bring the urethral opening to the tip of the penis via a procedure known as Urethroplasty. To straighten the penis. Circumssion of the foreskin should be avoided as this foreskin should be used for surgical repair. Surgery should be done preferably at the age of 6 -24 months of age.
  • 12. NURSING MANAGEMENT PREOPERATIVE CARE Preparing parents for child surgery. Psychological support should be given to the parents
  • 13. POST OPERATIVE CARE Monitor vital signs Catheter care should be given Put restraints so that child should not take out catheter or other tubings. Urine examination should be done to rule out any infection. Support and guidance of parents is very important.
  • 14. NURSING RESEARCH Background: Hypospadias is the most common birth defect among children affecting the penis characterized by ventral position of urethral meatus in which caused by arrest of normal development of the urethra. Aim of the Study: To evaluate the effect of pre- operative instructions for mothers on selected post- operative outcomes among their children with hypospadias.
  • 15. Subjects and Methods: A quasi-experimental research design (pre-post test) was used to achieve the aim of the current study. A convenient sample of 60 mothers having male children undergoing surgical repair of hypospadias participated in the current study, divided into two equal groups: 30 as a control group and 30 as a study group who were subject to the preoperative instructions. The setting was in-patient Pediatric Surgical Department at Cairo University Specialized Pediatric Hospital (CUSPH). The required data was collected through: 1- Structured interview (questionnaire); 2- Mothers' knowledge and reported practice assessment sheet (pre-post test) and 3- Post-operative outcomes assessment record.
  • 16. CONT Results: The study's results revealed that, children in the study group exposed to less early post-operative complications such as (bleeding, wound dehiscence, urinary obstruction and urinary catheter fall) than children in the control group. Late post-operative complications (fistula, meatal stenosis, urethral obstruction and infection) occurred in children in the study group less than those in the control group. Children in the study group had appropriate cosmetic appearance of the penis and functional outcome than children in the control group. Conclusion: The current study concluded that children whom mothers received the pre-operative instructions about hypospadias had improved outcomes in relation to less complications, higher cosmetic and functional outcomes than children in the control group.
  • 17. Recommendation: It was recommended that provision of pre and post-operative care of children undergoing hypospadias repair is mandatory to achieve satisfactory post-operative outcomes.