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Surgery Urethra & Penis e4258c7a

Most common type of hypospadias?

A
Glandular
B
Coronal
C
Penile
D
Perineal
High-Yield Explanation
Ans. A. Glandular. (Ref. Bailey and Love 26th/pg. 1360.)HypospadiasHypospadias occurs in one in 200-300 boys and is the most common congenital malformation of the urethra. The external meatus opens on the underside of the penis or the perineum, and the ventral aspect of the prepuce is poorly developed ( hooded prepuce').Hypospadias is classified according to the position of the meatus:# * Glanular or distal hvpospadia: most common form and does not usually require treatment. Opening is found near the head of the penis. The normal site of the external meatus is marked by a blind pit, although it occasionally connects by a channel to the ectopic opening on the underside of the glans.# * Coronal hypospadias. The meatus is placed at the junction of the underside of the glans and the body of the penis.# * Penile and penoscrotal hypospadias. The opening is on the underside of the penile shaft (.# * Perineal hvpospadias.This is the most severe abnormality.The scrotum is bifid and the urethra opens between its two halves. There may be testicular maldescent, which may make it difficult to determine the sex of the child.The more severe varieties of hypospadias represent an absence of the urethra and corpus spongiosum distal to the ectopic opening. The absent structures are represented by a fibrous cord, which deforms the penis in a downward direction (chordee).Rx: Glanular hypospadias does not need treatment unless the meatus is stenosed, in which case a meatotomy is performed. Surgery is indicated for other forms of hypospadias to improve sexual function, to correct problems with the urinary stream and for cosmetic reasons. A variety of plastic surgical procedures is described to correct the chordee and to re-site the urethral opening. Most procedures use preputial skin and so circumcision should be avoided until the hypospadias has been repaired.

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