6. HYPOSPADIAS
Urethral meatus is ventral in location
Meatus located proximal to the tip of
glans
Prepuce is hooded
Ventral curvature on erection
7.
8.
9. HYPOSPADIAS REPAIR
Straightening of the penis “Orthoplasty”
Extending the urethra to tip of the glans
“Urethroplasty”
Fashioning the new meatus “Meatoplasty”
Refashioning the glans around neo-urethra
“Glanuloplasty”
Covering the neo-urethra with skin
13. POSTERIOR URETHRAL VALVES
Remnant obstructing tissues at the distal end
of posterior urethra in males
Prenatal infravesical obstruction
Hydroureteronephrosis, distended bladder
and posterior urethra
Vesicoureteric reflux
Urosepsis
Common cause of renal insufficiency
20. EXSTROPHY – EPISPADIAS COMPLEX
Lack of development of the mesoderm of the
infra-umbilical region
Diastasis of the symphysis pubis
Bladder is opened to the outside
Epispadias in males
Bifid clitoris in the female
Bilateral inguinal hernias are common
23. SURGICAL REPAIR
Closure of bladder plate
Complete penile disassembly
Repair of epispadias
Ventral re-location of the urethra
Repair of the clitoris in females
Closure of the abdominal defect
• Simple closure in the first 72 hours
• Bilateral iliac osteotomy thereafter
Attention to continence at age 3 – 5 years