A Case Study for detecting and diagnosing Hypospadias
- 1. Department of Computer Science & Enggineering, University of Calcutta, India
CITATION
Samir Kumar B (2018) A Case Study for detecting and diagnosing Hypospadias. J Clin Nephrol Res 5(1): 1081
EDITORIAL
Passing urine is a natural phenomenon. The stream of urine has to go straight but can you ever imagine it fall on your foot or as a fountain in the bathroom. Consider a case of a patient who is eleven years old with a condition called “Hypospadias”.
Most boys are born with a penis that looks normal and works well. Some of them are born with a common condition called hypospadias. In Hypospadias penis is formed in such that not only doesn’t work well but also doesn’t look normal. Pediatric urologists have come up with many surgical techniques to fix this problem.
Birth defects, also called congenital disorders, treatment of kidney and bladder stones, cancer care, management of incontinence, infertility and erectile disorders are some of the areas where we excel. Lithotripsy, Endo-urology, TURP and laparoscopic urological surgeries are performed regularly. The centers also use the highly sophisticated da Vinci® robotic surgical system, the most advanced platform for minimally invasive surgery available today. Our team of nephrology and urology doctors is trained at the top centers in the world, our Nephrologists and Urologists work in tandem to ease the suffering of people with kidney and genitourinary tract diseases.
Hypospadias is a birth defect congenital condition in which the opening of the urethra is on the underside of the penis instead of at the tip. The urethra is the tube through which urine drains from your bladder and exits your body.
Surgery usually restores the normal appearance of your child’s penis. It is possible to make treatment of hypospadias so that most males can have normal urination and reproduction. In hypospadias, the opening of the urethra is located on the underside of the penis instead of at the tip. The opening of the urethra is within the head of the penis in most cases. Less often, the opening is at the middle or the base of the penis. Rarely, the opening is in or beneath the scrotum. The Signs and symptoms of hypospadias may include:
• Opening of the urethra at a location other than the tip of the penis
• Downward curve of the penis
• Hooded appearance of the penis because only the top half of the penis is covered by foreskin
• Abnormal spraying during urination
This young boy had underwent multiple surgical interventions to rectify it since initial years of his life but was not able to achieve what he must have intended to, rather than he faced complications in form of multiple fistulas. He came to me in a desperate situation having had 4 surgeries elsewhere and needing a permanent and satisfactory solution to his embarrassing situation. If hypospadias is not treated, it can result in:
• Abnormal appearance of the penis
• Problems learning to use a toilet
• Abnormal curvature of the penis with erection
• Problems with impaired ejaculation
Normally when there are many fistulas with Meatal Stenosis, we do a staged (multiple steps) surgery to rectify this including a possible graft from the buccal area (i.e., .tissue from inside of the mouth). In this case, the existing fistulas are made into one large fistula after closing the most distal of the fistulas, and then the corpus spongiosum is mobilized where we are able to achieve nice closure of the lateral fistulas with a good caliber neo urethral tube. The problem at hand was to have a barrier layer in between the skin and urethra. We did this by mobilizing the scrotal dartos – which is a thick and robust tissue to do the barrier job. This was followed by a meatal advancement and the final product was a complete success.The surgery is slightly unique because of the single stage repair of a crippled penis. It is been almost 6 months since the operation and there are no complications and the patient is passing urine as god intended.