✓ Newborn hypospadias, how to treat congenital malformation

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Newborn hypospadias, how to treat congenital malformation

During the pregnancy one of the major concerns of future parents is about health of the unborn child: at each ultrasound the tension is always high, will he be fine, the measurements will be normal, will there be problems? L'hypospadias newborn is a congenital malformation little known, however, which concerns 1 baby out of 300: what is it, how is it recognized and how can one intervene?

What is hypospadias of the newborn

Hypospadias is a congenital malformation which concerns i male fetuses and which can also be the cause of erroneous attribution of sex at birth. It is in fact an anomalous growth of external genital organs, which manifests itself already during embryonic life and which can take on different severity depending on the case. It is a malformation concerning the penis, therefore, and it is congenital, it cannot develop after birth. There are cases of anterior hypospadias, when the meatus (urinary orifice) is displaced from the norm, and others of average ipospadias, when the orifice is located halfway between the scrotum and the glans, or, in the most severe form, we speak of posterior hypospadias when even the meatus is located between the scrotum and the perineum.

Read also: Pregnancy with probable genetic malformations: "I didn't want to have an amniocentesis"

The causes of hypospadias

As we said, hypospadias is a condition that already develops in embryonic stage, and is usually due to problems related to the testosterone already at the gonadal level, or at a deficit ipofisario of the embryo, when it has to develop the external genitalia. It is not yet certain what the primary cause is, but studies speak of external factors such as viral diseases, chemicals, radiation or deficiencies.

How hypospadias is recognized

In many cases l'ipospadia it is diagnosed when the fetus is still in the belly, especially in the most serious cases, thanks to observation of the external and internal reproductive system. In other cases we notice the malformation at birth.

This congenital malformation could create confusion in the attribution of sex of the unborn child, for this reason, evaluations are often carried out by themselves of the endocrinologist and geneticist to understand. It happens, albeit rarely, that cases of hypospadias are associated with intersex, a condition in which the individual manifests both female and male sexual characteristics (which depend on chromosomes and sex hormones).

Read also: Will it be male or female? From science to popular beliefs

How and when hypospadias requires surgery

In some cases it is noticeable of the anomaly already during the pregnancy or to birth, but in less serious cases, in which the meatus it is just displaced, we might notice it some time later, particularly when the autonomous urination and the child fails to do pee-pee correctly, often misdirecting the jet. Over the years, the problem is also related to sex life because it has consequences about ejaculation. For this reason, even if the problem is mild and not the most serious, it would be good to intervene also to avoid running into it psychological complexes, particularly in adolescents and young men.

The operation it is therefore necessary in three cases: for one functional reason, that is, to put an end to urination problems; for sexual purposes, especially in the case of congenital curved penisoften associated with hypospadias; for aesthetic reasons, when these trigger complexes and psychological problems in the patient.

Obviously, the sooner you intervene the better: the best time is immediately after birth, between 4 and 18 months of life. In the event that no action is taken during this period (in which the course is simpler and the child does not notice anything), because it was not considered necessary or the malformation was not noticed, it is better to wait a few years, until the beginning of elementary school, because the intervention in younger children, but able to understand, has more disadvantages compared to other age groups (especially for course and trauma).

Anyone with hypospadias can undergo it to the repositioning and reconstruction of the urethral canal and therefore of the meatus. The operation takes place in general anesthesia and there are several surgical techniques. The operation is successful in 90% of cases, without any subsequent complications, while in very rare cases there are fistulas or stenosis that require a second operation.

L'hypospadias of the newborn it is a congenital malformation that affects males and develops already in the embryonic stage: it is however possible to correct it with a quick intervention already in the first months of the child's life.

SOURCES

Penile and urethral anomalies

Congenital defects of the genital organs

UAE Pediatric Urology Guidelines

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