Documenti di Didattica
Documenti di Professioni
Documenti di Cultura
HIPOSPADIA
Arista Prima Nugrahani
NIM 152010101003
Pembimbing
dr. Ogi Bahaurini Gumilar Sp.U
Purnomo, Basuki B. 2012. Dasar-Dasar Urologi Edisi ketiga. Malang. CV Sagung Seto
Wein AJ, Kavoussi LR, Novick AC, Partin AW, Peters CA. Campbell-Walsh Urology 10th Edition. Campbell-Walsh Urology. 2012. 3400 p.
Epidemiologi
Angka kejadian hipospadia 3,2 per 1000 kelahiran hidup
Insidensi pada setiap negara bervariasi
Purnomo, Basuki B. 2012. Dasar-Dasar Urologi Edisi ketiga. Malang. CV Sagung Seto
Wein AJ, Kavoussi LR, Novick AC, Partin AW, Peters CA. Campbell-Walsh Urology 10th Edition. Campbell-Walsh Urology. 2012. 3399 p.
Springer, A., Heijkant M. V., Baumann, S. 2016. Worldwide Prevalence of Hypospadias. Journal of Pediatric Urology Vol 12 (2 )
Embriologi dan Patofisiologi
Purnomo, Basuki B. 2012. Dasar-Dasar Urologi Edisi ketiga. Malang. CV Sagung Seto
Manifestasi klinis
Meatus Uretra Externa (MUE)
pada ventral penis.
Preputium pada ventral penis (-),
menumpuk di dorsal penis
(dorsal hood)
penis kurvatura ke ventral
(melengkung) ketika ereksi,
maka dapat disimpulkan adanya
chordee
Purnomo, Basuki B. 2012. Dasar-Dasar Urologi Edisi ketiga. Malang. CV Sagung Seto
Anomali bawaan
Kriptorkismus
Utrikulus prostat
Disorder of sex development (DSD)
de Jong. 2011. Buku Ajar Ilmu Bedah. Jakarta. Penerbit Buku Kedokteran ECG
Wein AJ, Kavoussi LR, Novick AC, Partin AW, Peters CA. Campbell-Walsh Urology 10th Edition. Campbell-Walsh Urology. 2012. 3505-3536 p.
Diagnosis
Pemeriksaan fisik
Inspeksi segera setelah kelahiran : MUE letak ventral
proksimal, dorsal hood, chordee, ventral curvature, celah pada
skrotum bagian medial
Pemeriksaan penunjang
- Urethroscopy
- Cystoscopy
Hypospadias : Disorder of The Penis and Male Urethra. Smith's General Urology. 18th Edition. 2013 : 629-631 p.
Penatalaksanaan
Tujuan Operasi
1) Kosmetik
(fungsi miksi & fungsi
seksual normal)
2) Penis tumbuh
dengan normal
Tekgul S, Dogan HS et al. Paediatric Urology. EAU Pocket Guidelines. EAU Guidelines 2015 edition
Prosedur operasi
Chordectomi
Urethroplasty
Hadidi AT. Hypospadias Surgery. International Workshop on Hypospadias Surgery. Germany : Medical University Vienna; 2006.p.1-19
Hipospadia tipe distal
Hipospadi tipe distal,
tanpa chordee
Teknik TIP
Insisi midline sampai dasar
uretra
Diameter uretra sampai
dasarnya tidak boleh
kurang dari 1 cm
Kateter ditinggalkan selama
7 hari
Hadidi AT. Hypospadias Surgery. International Workshop on Hypospadias Surgery. Germany : Medical University Vienna; 2006.p.1-19
Subramaniam R, Spinoit AF, Hoebeke P. Hypospadias repair: An overview of the actual techniques. Semin Plastic Surgery. 2011;25(3):206–12.
Mouriquand, Demede, Gorduza, Mure. Hypospadias. In: Rink, Mouriquand, Gearhart. Pediatric Urology. Philadelphia: Elsevier. 2010. pp. 535-552.
Hipospadia tipe glanular
Teknik MAGPI
Traksi sederhana menggerakkan meatus ke
ujung glans
Post op tidak perlu meninggalkan kateter
Hadidi AT. Hypospadias Surgery. International Workshop on Hypospadias Surgery. Germany : Medical University Vienna; 2006.p.1-19
Subramaniam R, Spinoit AF, Hoebeke P. Hypospadias repair: An overview of the actual techniques. Semin Plastic Surgery. 2011;25(3):206–12.
Mouriquand, Demede, Gorduza, Mure. Hypospadias. In: Rink, Mouriquand, Gearhart. Pediatric Urology. Philadelphia: Elsevier. 2010. pp. 535-552.
Teknik Y-V modifikasi
Mathieu
hasil kosmetik yang
lebih baik
Hadidi AT. Hypospadias Surgery. International Workshop on Hypospadias Surgery. Germany : Medical University Vienna; 2006.p.1-19
Subramaniam R, Spinoit AF, Hoebeke P. Hypospadias repair: An overview of the actual techniques. Semin Plastic Surgery. 2011;25(3):206–12.
Mouriquand, Demede, Gorduza, Mure. Hypospadias. In: Rink, Mouriquand, Gearhart. Pediatric Urology. Philadelphia: Elsevier. 2010. pp. 535-552.
Hipospadia tipe mid-penile dan proksimal
Teknik Onlay Preputial Flap
preputium bagian dalam didiseksi dan
dirotasikan ke arah ventral bersama
dengan pedikelnya
Hadidi AT. Hypospadias Surgery. International Workshop on Hypospadias Surgery. Germany : Medical University Vienna; 2006.p.1-19
Subramaniam R, Spinoit AF, Hoebeke P. Hypospadias repair: An overview of the actual techniques. Semin Plastic Surgery. 2011;25(3):206–12.
Mouriquand, Demede, Gorduza, Mure. Hypospadias. In: Rink, Mouriquand, Gearhart. Pediatric Urology. Philadelphia: Elsevier. 2010. pp. 535-552.
Teknik Tubularized Preputial Flap
Eksisi pelat uretra
Manuver pemanjangan dari
preputium bagian dalam
Jika teknik MAGPI tidak mungkin
dilakukan
Hadidi AT. Hypospadias Surgery. International Workshop on Hypospadias Surgery. Germany : Medical University Vienna; 2006.p.1-19
Subramaniam R, Spinoit AF, Hoebeke P. Hypospadias repair: An overview of the actual techniques. Semin Plastic Surgery. 2011;25(3):206–12.
Mouriquand, Demede, Gorduza, Mure. Hypospadias. In: Rink, Mouriquand, Gearhart. Pediatric Urology. Philadelphia: Elsevier. 2010. pp. 535-552.
Teknik Dorsal Inlay
Dengan kulit cangkok (kulit penis, paha, atau mukosa bucal)
Hadidi AT. Hypospadias Surgery. International Workshop on Hypospadias Surgery. Germany : Medical University Vienna; 2006.p.1-19
Subramaniam R, Spinoit AF, Hoebeke P. Hypospadias repair: An overview of the actual techniques. Semin Plastic Surgery. 2011;25(3):206–12.
Mouriquand, Demede, Gorduza, Mure. Hypospadias. In: Rink, Mouriquand, Gearhart. Pediatric Urology. Philadelphia: Elsevier. 2010. pp. 535-552.
Teknik Bracka Dua Tahap
insisi sirkumferensial dibuat
proksimal sulkus koronal
chordee di eksisi
mempersiapkan kulit cangkok
revaskularisasi dari kulit
cangkok
Hadidi AT. Hypospadias Surgery. International Workshop on Hypospadias Surgery. Germany : Medical University Vienna; 2006.p.1-19
Subramaniam R, Spinoit AF, Hoebeke P. Hypospadias repair: An overview of the actual techniques. Semin Plastic Surgery. 2011;25(3):206–12.
Mouriquand, Demede, Gorduza, Mure. Hypospadias. In: Rink, Mouriquand, Gearhart. Pediatric Urology. Philadelphia: Elsevier. 2010. pp. 535-552.
Teknik Lateral Based (LB) flap
Hadidi AT. Hypospadias Surgery. International Workshop on Hypospadias Surgery. Germany : Medical University Vienna; 2006.p.1-19
Subramaniam R, Spinoit AF, Hoebeke P. Hypospadias repair: An overview of the actual techniques. Semin Plastic Surgery. 2011;25(3):206–12.
Mouriquand, Demede, Gorduza, Mure. Hypospadias. In: Rink, Mouriquand, Gearhart. Pediatric Urology. Philadelphia: Elsevier. 2010. pp. 535-552.
Komplikasi
Pedarahan Fistula
Infeksi Meatal Stenosis
Jahitan terlepas Striktur Uretra
Nekrosis flap Divertikulum Uretra
Snodgrass WT. Hypospadias. In: Pediatric Urology. Totowa, NJ: Humana Press; 2011. 90-177 p.
Terimakasih