Parent & Patient Information System 06/09/2015 Page35 / 51 Paraphimosis It is unavailability to turn the prepucial skin to its original position after retracting it. A circular band forms and it prevents the return of blood from glans to circulation. Glans starts to enlarge and be painful. If not corrected surgically it causes problems in glans perfusion and may prevent voiding. The skin can be returned to its former position under local or general anesthesia. If these attempts fail, circumcision is indicated. Hypospadias In hypospadias patients, the external urethral meatus (most outer opening of urinary system at the tip of penis) is located downward on penile shaft. The degree of severity of disease is dependent on the level of meatus where it becomes severe as the location comes closer to scrotum or lower. Another finding is the lacking of prepucial skin over the skin ventrally. Embryologically, the formation of prepucium and the outer urinary tract is completed by the tubularization of these structures by effect of in utero dihydrotestosterone (a kind of androgenic hormone). In cases where the hormone affect is inadequate or the organ is not responsive to this hormone, problems occur during this tubularization process and hypospadias occurs. It is seen in 1 of 250 boys. The incidence is thought to be increasing. The son of a hypospadiac father or the brother of a hypospadiac boy has an increased risk of having hypospadias. Environmental factors (pesticides, food preservatives, drugs, hormones used in agriculture and livestock industry, industrial materials, anti-oxidants, phytoestrogens, etc.) seem to have an effect on the increased incidence rates. Boys who were born as a result of assisted reproductive techniques also have an increased risk. The diagnosis is purely by physical examination. Associating diseases as undescended testis in 10% and inguinal hernia in 15% should also be sought. In patients who have a severe hypospadias plus undescended testis, there is a considerable risk of having intersex condition and chromosomal abnormalities. Hypospadias is not a life-threatening but life quality-decreasing disease. Patients are mostly unable to void in standing position and may have penile deviations (chordee) causing problems in sexual life in the future. These problems are corrected by surgery.
RkJQdWJsaXNoZXIy NjM1NTk=