HYPOSPADIASI

S
HYPOSPADIASIS
:HYPOSPADIASIS IS A CONGENITAL DEFECT IN WHICH THE
OPENING OF THE URETHRA (URETHRAL MEATUS/PEE-HOLE)
IS ON THE UNDERSIDE (DORSAL) OF THE PENIS, INSTEAD OF
THE TIP.

TYPES:
CAUS
E
1. MALFUNCTION IN THE ACTION OF THE HORMONES
2. IDIOPATHIC

RISK FACTOR
• Family history

• Genetics
• Maternal age over 35
• Exposure to certain substances during pregnancy
 CLINICAL
MANIFESTATION
1. OPENING OF THE URETHRA AT A LOCATION OTHER THAN THE TIP
PENI
OF THE
S
2. ABNORMAL SPRAYING DURING URINATION
3. DOWNWARD CURVE OF THE PENIS(CHORDEE)
4. PENIS
HOODEDIS COVERED BY OF PENIS BECAUSE ONLY THE TOP HALF OF
APPEARANCE
FORESKIN
THE
LATER ON:
1. SEXUAL DYSFUNCTION
2. INFERTILITY
3. PSYCHOSOCIAL PROBLEM
DIAGNOSTIC
EVALUATION
1. PHYSICAL EXAMINATION
2. RENAL ULTRASOUND
3. INTRAVENOUS PYELOGRAM
4. VOIDING CYSTOURETHROGRAPHY
 MANAGEMEN
T
1.HORMONAL THERAPY

2..SURGERY
 :

• DONE USUALLY BEFORE THE CHILD STARTS TO GO TO SCHOOL(6-12

MONTHS)
• SURGERY INVOLVES REPOSITION OF THE URETHRAL OPENING, STRAIGHTEN THE PENIS
AND CORRECTION OF THE HYPOSPADIAS USING TISSUE GRAFT FROM THE FORESKIN.
• THAT IS THE REASON WHY INFANTS WITH HYPOSPADIASIS SHOULD NOT BE
CIRCUMSISED, FORESKIN SHOULD BE PRESERVED FOR LATER SURGICAL REPAIR.
NURSING
MANAGEMENT
ASSESSMEN
T
1. HISTORY
2. PHYSICAL EXAMINATION
 NURSING
DIAGNOSIS
1. ACUTE PAIN RELATED TO PHYSICAL FACTORS:DAMAGE TO THE SKIN
:RELIEF FROM PAIN: ENCOURAGE USE OF RELAXATION TECHNIQUES; APPLY ICE
COMPRESS AS INDICATED; AND EDUCATE PARENTS THAT MEDICATIONS WILL
PREVENT PAIN AND RESTLESSNESS AND ALLOW FOR HEALING.

2.IMPAIRED URINARY ELIMINATION RELATED TO MECHANICAL TRAUMA

FROM SURGERY
:IMPROVE URINARY ELIMINATION: ENCOURAGE HIGH FLUID INTAKE AFTER CATHETER
REMOVED, OFFER FAVORED CHOICE OF LIQUIDS HOURLY; AND INSTRUCT PARENTS TO
NOTIFY THE PHYSICIAN OF CHANGES IN THE URINARY PATTERN OR INABILITY TO
VOID.
3. ANXIETY RELATED TO THREAT TO SELF CONCEPT;CHANGE IN HEALTH
STATUS AND ENVIRONMENT
:Lessen anxiety: Encourage verbalization of concerns and allow time for parents and child to ask
questions about condition, procedures, recovery; Answer questions calmly and honestly; use pictures,
drawings, and models for information; and reassure parents and child that defect or surgery will not
compromise sexual activity and will not affect reproductive ability.

4. RISK FOR INFECTION RELATED TO INADEQUATE PRIMARY DEFENSES

:Prevent infection: Obtain urine specimen for culture and sensitivities as indicated; inform parents to
avoid allowing the child to straddle toys, play in a sandbox, swim, or engage in rough activities until
advised by the physician; and apply sterile technique during dressing changes, catheter care or
draining urine bag.
 COMPLICATION
S
ACUTE POSTOPERATIVE COMPLICATION OF HYPOSPADIAS
REPAIR
 BLEEDING AND HEMATOMA
 WOUND INFECTION
 SKIN NECROSIS
 FISTULA(SMALL OPENING BETWEEN URETHRA AND IN THE SKIN OF PENIS)
 PENILE TORSION(ROTATED OR TWISTED PENIS FROM THE AXIS)