Hypospadias Prepared by : Sabah Salim Under supervision of : Dr. Qadir Mohemed 1 in every 250 male Causes Due to a wide range of known and unknown endocrine, genetic, and environmental factors. however, the specific etiology of hypospadias cannot be determined. Risk Factor Family history Genetics Maternal age over 35 Exposure to certain substances during pregnancy ***further studies are needed C/F Rx Some forms of hypospadias are very minor and do not require surgery. Surgical (Urethroplasty , Repair) Hypospadias repair Done between 6mo-2year should not be circumcised at birth ? Mild defects repaired in 1 procedure. Severe defects need 2 or more procedures. Procedure Anastomotic urethroplasty. Buccal mucosal onlay graft Scrotal or penile flap (graft) Johansen's urethroplasty. Surgery is not needed if the condition does not affect normal urination while standing, sexual function, or the deposit of semen. Anastomotic urethroplasty. The success rate is above 95%, and is considered the "gold standard" of surgical repair options. It is used when strictures are less than 2 cm in length, however, some surgeons have had success with defects approaching 3 cm in length. Bovie knife Prevent damage to nerves One stage And Two Stage Surgery Complications A hole that leaks urine (fistula) Large blood clot (hematoma) Scarring or narrowing of the repaired urethra Infection If the repair is not done, problems may occur later on such as: Difficulty controlling and directing urine stream A curve during erection Decreased fertility Embarrassment about appearance. …Thank You