Hypospadias is the most common birth defect of the urethra and penis in boys. It consists in the underdevelopment of the circumferential section of the coil. In this defect, the urethra does not reach the top of the glans and its opening is located on the ventral (bottom) side of the penis, on the scrotum or on the perineum. A string of fibrous connective tissue, called a string, runs from the incorrectly located external opening of the urethra to the glans, which shortens and bends the penis downwards. The dorsal side of the glans is covered with an excessively developed hood-shaped foreskin. The unequivocal cause of hypocrisy has yet to be fully understood.
Hypocrisy is the most common birth defect of the urethra and penis in boys. It consists in the underdevelopment of the circumferential section of the coil. In this defect, the urethra does not reach the top of the glans and its opening is located on the ventral (bottom) side of the penis, on the scrotum or on the perineum. A string of fibrous connective tissue, called a string, runs from the incorrectly located external opening of the urethra to the glans, which shortens and bends the penis downwards. The dorsal side of the glans is covered with an excessively developed hood-shaped foreskin. The unequivocal cause of hypocrisy has yet to be fully understood.
The occurrence of this damage is explained by the incomplete development of male characteristics within the fetal sexual organs due to hormonal disorders in a certain period of fetal development. If the embryological development of the urethra is inhibited, hypospadias is revealed.
The process of shaping the urethra begins in the proximal part around the 9th week of pregnancy and gradually progresses in the peripheral direction until around 14. week of fetal life. Depending on the period in which the damaging factor is active, the defect will develop on a different level: from the perineum to the glans. Research indicates that hypospadias is a multi-factorial birth defect, which means that genetic, hormonal and environmental factors may be responsible for its development. The empirical risk of repeating this defect in subsequent children is estimated at about 1%. In a little boy with hypospadias, apart from a visible defect in the structure of the penis, urination disorders may come to the fore. The incorrectly located outer opening of the urethra is often even narrowed.
This is a significant obstacle to the free flow of urine. Urinary retention leads to a widening of the urinary tract and promotes the development of infections. In cases of scrotal and perineal hypocrisy, it is not possible to urinate in a standing position, and the accompanying flexion of the penis causes the stream of urine to splash over the perineum and on the child's clothing, which can lead to chronic skin reactions. Since hypophysis concerns the segment of the urethra located distal to the urethral sphincter, there is no incontinence disturbance. Using modern equipment: magnifying glasses, micro-tools, extremely thin needles and threads, precise operations can be performed in very small patients. The use of magnifying loupes gives the surgeon a detailed insight into the surgical field, ensuring excellent results, especially in such difficult procedures as plastic surgery of hypospadias in young children. By increasing the comfort of work and improving the results of treatment, loupes have become an inseparable equipment of a modern pediatric surgeon.
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