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REFERAT

HIPOSPADIA
Arista Prima Nugrahani
NIM 152010101003

Pembimbing
dr. Ogi Bahaurini Gumilar Sp.U

SMF/LAB ILMU BEDAH


RSUD DR. SOEBANDI JEMBER
FAKULTAS KEDOKTERAN UNIVERSITAS JEMBER
MEI 2019
Definisi
 kelainan kongenital berupa muara uretra yang terletak di
sebelah ventral penis dan sebelah proksimal ujung
penis.

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

Langman, J. "Embriologi kedokteran langman." (2009).


Klasifikasi

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

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