DR SANDIP KUMAR SINHA
Daktari wa Upasuaji wa Watoto, Daktari wa Urolojia wa Watoto na Upasuaji wa Laparoscopic ya Watoto
Taarifa kwa Wazazi
Hypospadias
Ugonjwa huu ni nini?
Hypospadias inarejelea nyama ya urethra ("shimo la mkojo") ambayo iko kando ya chini, badala ya ncha ya uume. Uwazi unaweza kuwa chini ya uume, kwenye glans au hata haupo kabisa, na mkojo unatoka kwenye kibofu nyuma ya uume.
Je, inatambuliwaje?
Hypospadias ni kutambuliwa na uchunguzi wa kliniki tu.
Je, inatibiwaje?
Upasuaji ndio njia pekee ya kutibu hali hii.
Wakati inapaswa kuendeshwa?
Upasuaji wa Hypospadias unapaswa kufanywa baada ya karibu miezi 9 ya umri, kulingana na saizi ya uume.
Je, kuna njia nyingine mbadala za matibabu?
Usimamizi wa matibabu katika hali hii haufanikiwa.
Ni nini ninachohitaji kujua kabla ya upasuaji wa mtoto wangu?
Soma kijitabu cha maelezo cha “Yote unayohitaji kujua kabla ya upasuaji wa mtoto wako” kwenye tovuti.
Upasuaji unafanywaje?
Daktari wa upasuaji hutumia ngozi kwenye uume au prepuce kuunda mrija ili uwazi wa urethra ufanyike kwenye ncha ya uume. Wakati mwingine upasuaji wa hatua unahitajika
Maoni
Kwa maelezo zaidi ya upasuaji, wasiliana na daktari wako wa upasuaji
Picha na video Zinazohusiana
Picha chache za hatua nilizofanya zimetolewa hapa kwa madhumuni ya kujifunza
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Urethroplasty
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Reconstruction of urethra can be performed in a single stage or in a two-stage procedure.
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As a general rule , a single-stage repair is appropriate for distal, mid shaft and proximal hypospadias without significant chordee.
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A two-stage repair is generally reserved for penoscrotal, scrotal and perineal hypospadias with chordee.
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To correct hypospadias and achieve a terminal meatus( urethroplasty), one may use one of the following tissues:
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Urethral plate
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moblisation
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tubularization
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Urethral plate (UP) augmentation
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Urethral plate (UP) replacement
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The author prefer tubularisation of the urethral plate as their preferred one-stage method in children with wide urethral plate(>9mm). However, whenever in doubt, authors prefer to augment urethra, either by perimeatal flap or lateral based flap, even in anterior hypospadias
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Meatoplasty and Glanuloplasty.
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Creation of wide meatus at tip is aim in all hypospadias repair. the two steps, meatoplasty and glanuloplasty deal with this part of repair. However, it should be kept in mind that tight repair of glans can lead to meatal stenosis, needing dilatation a d many other complications.
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Scrotoplasty
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In hypospadias with pulled up scrotum, release of chordee leads to normal position of scrotum. in children with penoscrotal transposition, this step can be combined with or can be done in another step of hypospadias repair
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skin cover
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skin rearrangement os done to either give circumcised look or prepucioplasty is done to give normal appearance. Prepucioplasty is associated with more chances of complication.
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