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salutari tuturor! baietelul meu de 3 saptamani are hypospadias. cine stie ceva despre acest diagnostic? tot caut pe net informatii... ni s-a spus ca e nevoie de interventie chirurgicala dupa varsta de 3 luni.

multumesc anticipat pentru orice fel de raspuns.

 

mama cea ingrijorata a Mariei, care il pupa toata ziua pe fratiorul ei cel mic, Stefanut [pup]

 

strumfi2004

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Uite ce am mai gasit intr-un document pe care il salvasem acum ceva timp...Din pacate nu am adresa site-ului dupa care am salvat informatia. Dar poti cauta tu cu google sau cu un alt motor de cautare...

 

 

What is hypospadias?

 

Hypospadias is a common birth defect of the penis. Usually, the urethral opening (the opening of the tube that carries urine out of the penis) appears at the very tip of the head (or glans) of the penis. In hypospadias, the opening can appear anywhere on the underside of the penis. In a mild case, the opening may be just below the head of the penis (coronal). In more severe cases, the opening can be anywhere from the middle of the underside of the penis (mid-shaft) to below the place where the penis and scrotum meet (perineal). Frequently there is a downward curving of the penis called chordee. This curvature may be more pronounced when the penis is erect. The foreskin is also incomplete and has the appearance of a dorsal hood (skin covering only the top and sides of the head of the penis).

 

How often does hypospadias occur?

 

This is a relatively common condition that occurs in approximately one out of every 300 male births. Most cases of hypospadias (approximately 90%) are of the milder type.

 

What causes hypospadias?

 

The urethra (tube that caries urine) is formed between the 6th and 14th week of pregnancy. There is evidence that in some cases a lack of male hormone produced by the fetus may cause the urethra to stop growing before it reaches its full length. However, in most cases no cause is identified. Hypospadias is not usually caused by anything the parents did or did not do during pregnancy. (In rare cases, progesterone taken by the mother early in pregnancy may cause hypospadias.)

 

How will this affect my child?

 

In mild cases, there is little effect from hypospadias. In more severe cases, because the unusually placed opening of the hole will force urine to spray downwards, a boy will find it difficult or even impossible to urinate from a standing position. If chordee is involved, an adult male may have difficulty with sexual functioning due to the curvature of the penis. Unless the hypospadias is very severe, the hypospadias should not affect a man’s fertility. The hypospadias does not affect the ability to hold and release urine, nor will it result in more urinary infections. However, the appearance of the foreskin can be a source of embarrassment or self-consciousness.

 

Treatment: What can be done?

 

In mild cases, surgery is optional, based on an evaluation of the urinary stream, the straightness of erections and the way it looks. In moderate to severe cases, surgery is almost always recommended to establish normal function. The goal of surgery is first to straighten out any curvature of the penis and second to remake the part of the urethra that didn’t form. Except for the most severe cases, hypospadias can be corrected in one operation as an outpatient. Depending on the severity of the problem, a second more minor procedure may be needed about 6 months later in 5 to 25% of cases to correct a small leak or a narrowing.

 

What is this type of surgery like?

 

There are several surgeries that are available to correct this anomaly. The choice of surgery is based on multiple factors, including the position of the urethral opening, the appearance of the glans, the severity of the chordee, the surgeon’s preference, etc. The penis needs to be straight during erection. This is done primarily by releasing fibrous bands on the underside of the penis (ventral aspect). Sometimes this is not sufficient and more elaborate surgery is needed. Once the penis is straight, the urethra may need to be lengthened. The foreskin can be used for this purpose. The foreskin is also used to recover the ventral skin defect (on the underside of the penis). The need for urine drainage and stenting (inserting a catheter) as well as the length of time of this drainage depends upon the techniques used and the severity of the hypospadias.

 

When will my son be scheduled for this surgery?

 

Surgical correction is best done when anesthesia is safe and the penis is large enough. Most surgeons will recommend performing the procedure at an early age so that a child will not have a memory of the experience. Generally this is when the child is between 6 and18 months. Frequently, the surgery can be done as outpatient procedure, which means that your son will not have to stay overnight at the hospital. The alternative is to wait until the child is old enough to make his own informed decision about surgery. However, the risks of complications related to the surgery are higher in adults than children.

 

How long will the surgery take?

 

The length of the surgery depends on how curved the penis is and exactly where and how low the opening is on the penis. Most operations take between 1 and 3 hours.

 

How will hypospadias affect my son in the future?

 

If your son has his hypospadias repaired surgically, it is likely that the penis will function normally. He will be able to urinate from a standing position and will be able to engage in normal and comfortable intercourse. Recent research studies find that surgically corrected hypospadias should not be considered as a risk factor for poor psychosocial adaptation in childhood. However, repeated genital surgeries may slightly increase the risk of emotional problems.

Studies of boys who had surgery for hypospadias repair show no differences in the average ages at which various sexual milestones (such as kissing, necking and sexual intercourse) were reached as compared to boys without hypospadias repair. However, the condition or its surgical repair may be associated with greater self-consciousness and dissatisfaction with the appearance of the penis. This observation, together with the knowledge that boys and men with hypospadias are sometimes unwilling to seek advice on their own when they experience difficulties, suggests that combining surgical management with psychological counseling might be helpful. This applies mainly to the more severe forms of hypospadias. For older children, the availability of a mental health professional who is introduced to the child during the period of surgery and follow-up may lessen the perceived stigma associated with seeking out counseling when it would be useful.

 

Nicoleta si [zana]Alexia (21 aprilie 2005)

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Ti-am trimis un PM. Scrie-mi si pe mail.

Afara prima operatie se face intre 9 luni si 18 luni. La noi majoritatea medicilor o fac dupa 2 ani. Dr. Basca de la Grigore Alexandrescu o face si mai devreme.

Noi i-am facut operatia la 3 ani si 4 luni. Am constatat ca a fost foarte bine. Atat copilul cat si eu am suportat mai bine conditiile de spital.

Din pacate articolele de pe net vad numai partea roz... totul pare atat de simplu, dar nu este.

Sansa de reusita a operatiei depinde de gradul de hipospadias in primul rand.

Cine l-a diagnosticat pe copilasul tau? Are penisul curbat? Gaurica unde este fata de varf?

Scrie-mi pe mail... am citit mult, am experienta operatiei si vreau sa va ajut pe toate care treceti prin asta pentru ca stiu cum este...

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si bebele meu are acelasi diagnostic. tot ce te sfatuiesc e sa mergi cu el la doctor cat mai repede pentru ca este intr-adevar nevoie de interventie chirurgicala, dar nu acum cat este mic, ci cand va mai creste. mie doctorul mi-a recomandat operatia pana intra bebe la scoala, deoarece in momentul in care intra intr-o colectivitate sa nu aiba probleme de ordin psihic. stii cum sunt copiii, rad si pentru orice copil asta inseamna din start un complex de inferioritate. apoi mai este problema ca dupa operatie copilul trebuie sa stea intubat vreo 7 zile, pentru ca fiind operat trebuie sa urineze si pentru a nu se infecta i se pune o sonda.iar pentru asta trebuie sa vb. cu el si sa-i explici sa nu se miste , etc.

eu cam atat pot sa-ti spun despre acest diagnostic. si eu speram sa-l opereze cand e mai mic si nu stie, dar cand am auzit ca il vor opera pe la 3-4 ani, m-am cam desumflat. ma gandeam daca chiar este necesara. dar cica este.sanatate lui bebe si sa aduci vesti bune.

 

http://community.webshots.com/user/bogdidicris

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Si eu imi pusesem problema ca nu face din picioare si o sa se simta prost. Adi a mers la gradinita dupa operatie si putea face pipi din picioare, dar nu vroia...Eu chiar ma bazam pe asta... ca-i vede pe ceilalti, dar de unde... Nu s-a simtit niciodata altfel fata de ceilalti... Poate a contat mult atitudinea noastra, a celor din jur... Niciodata nu am dat de inteles ca este ceva in neregula cu el. Il puneam si in parcuri cand era mic si facea ca fetele... nu am facut o tragedie din asta... I-am spus si doctorului ca nu vrea sa faca din picioare, iar el ne-a zis sa nu stresam copilul...

Si acum face cum ii vine... indiferent daca este la gradinita sau acasa... Doar pe afara sau la toaletele publice face din picioare...

Deci atentie... conteaza foarte mult atitudinea voastra...

Cand ne-am dus la operatie i-am explicat cam ce se intampla... totul intr-o aura foarte frumoasa, culminand cu faptul ca va dormi in pat cu mami...Nici in spital nu am lasat sa rabufneasca toata agitatia mea.. Cert este ca a spus ca lui i-a placut in spital...

Ar fi multe de indreptat in atitudinea asistentelor de acolo... eu consider ca se puteau face multe,fara bani, ca sederea sa fie si mai placuta...

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