Hypospadias.pdf Advance concept in nursing

ADvance concept in nursing Hypospaduasis

1. Hypospadias
Prepared by
Ms. Maira

2. Hypospadias
It 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.

3. Cont…
Hypospadias is common and doesn't cause
difficulty in caring for your infant.
Surgery usually restores the normal
appearance of your child's penis.
With successful treatment of hypospadias,
most males can have normal urination and
reproduction.

4. Causes
—Hypospadias is present at birth (congenital).
As the penis develops in a male fetus, certain
hormones stimulate the formation of the
urethra and foreskin.
—Hypospadias results when a malfunction
occurs in the action of these hormones,
causing the urethra to develop abnormally.
—In most cases, the exact cause of hypospadias
is unknown. Sometimes, hypospadias is
genetic, but environment also may play a
role.

5. Risk Factors
Family history This condition is more
common in infants with a family history of
hypospadias.
Genetics Certain gene variations may play a
role in disruption of the hormones that
stimulate formation of the male genitals.
Maternal age over 35 Some research
suggests that there may be an increased risk
of hypospadias in infant males born to
women older than 35 years.

6. Cont…
Exposure to certain substances during
pregnancy There is some speculation
about an association between hypospadias
and a mother's exposure to certain
hormones or certain compounds such as
pesticides or industrial chemicals, but
further studies are needed to confirm this.
Chemical or pesticide exposure.

7. Sign & Symptoms
Fertility Problems
Psychological problems may arise
Abnormal urine stream
Sexual Dysfunction later in life.

8. Assessment
Abnormal pattern of voiding.
Stream of urine may be deflected
downward.
 Child voids in sitting position in
penoscrotal and perineal Hypospadias.
 In Glandular or coronal hypospadias
child able to voids in standing position, by
tilting the penis slightly upward

9. Management
 There is no medical management for this
defect.
 Surgery may be recommended for its correction
and the goals of surgery are:-
 To bring the urethral opening to the tip of the
penis via a procedure known as Urethroplasty.
To straighten the penis.
 Circumcision of the foreskin should be avoided
as this foreskin should be used for surgical
repair.
Surgery should be done preferably at the age of
6 -24 months of age.

10. Treatment
Surgeons prefer to do hypospadias surgery
in full-term and otherwise healthy boys
between the ages of 6 and 12 months.
When this isn’t possible, hypospadias can
be fixed in children of any age, even in
adults.
If the penis is small, your doctor may
suggest testosterone (male hormone)
treatment before surgery.

11. Nursing Management
Assess and manage pain.
Promote wound healing and infection
prevention.
Provide education on postoperative care
and hygiene.
Support the child and family emotionally
throughout the surgical and recovery
process.

12. Cont…
— Preoperative Care
—Preparing parent’s for child surgery.
—Psychological support should be given to the
parents
—Post operative Care
—Monitor vital signs
—Catheter care should be given
— Put restraints so that child should not take out
catheter or other tubings.
—Urine examination should be done to rule out any
infection.
— Support and guidance of parents is very important.