Hypospadias Perineal

Hypospaedia is a pathology in which the unformed remainder of the urethra is localized at the base of the penis, and the opening of the urethra is located between the scrotum and the anus. With this form of the disease, urea is excreted not only outward, but also towards the thigh, and sexual intercourse is complicated by pain and traumatic consequences.

Perineal hypospadias (genitoperineal hypopaedia) is found among male infants - between 4 and 12 months from birth. In 98% of cases, this pathology is of a chromosomal nature, being detected when parents become carriers of a dominant gene present in them on a certain type of X chromosome.

Hypospadias in children

The disease is typical for boys born after 37 weeks of pregnancy. It is also often found in low-weight newborns, which indicates the presence of a genetic predisposition to the manifestation of the disease. Symptoms of the pathology begin to develop already in the first days of a baby’s life. In boys aged 3-5 months, the main signs of hypospadias appear.

Clinical manifestations of the disease

1. Dislocation, excessive mobility of the testicles due to the absence of the scrotum. 2. Low penis mobility. 3. Immaturity of the testicles - increase in size, reddish-bluish tint. 4. Scrotal cyst - accompanied by severe swelling, which is characterized by reddish rashes and blurry boundaries. The size of the neoplasm can vary: from small to 2 cm - giant cystic neoplasms up to 15 cm in diameter. Rarely, cystic processes are located throughout the scrotum. 5. Increased body temperature. 6. Pain in the lower abdomen - does not spread beyond the groin area. 7. Absence of spontaneous leakage of urine 7. Indistinct discharge from the anus - pathological impurities, sanguineous

Hypospadias is a congenital defect in the development of the urethra and scrotum in men, characterized by underdevelopment or lack of skin rudimentary penis - the clitoris or penis - in the lumen of the vulva, the internal opening of the urethra (urinary) canal, the bladder or the anterior part of the perineum, as well as the underdevelopment of its external opening next to it, partially or completely located inside the defect. It is considered an anomaly of the development of the genitourinary system. The main clinical variants of G. are hypospadias of the glans and hypospadias of the penis. In addition, isolated P. of the urinary opening is often found, the so-called “suprapubic” variety, in which the external opening of the urinary canal is split in the middle or located above the pubis, bringing out only its slit. The anatomical basis of all main types of genitalia is the defective posterior wall or septum of the anterior part of the corpus spongiosum of the clitoris, due to which the cloaca opens at the end of the pubis in front of the clitoral opening. The cloaca is formed as a result of complete or partial epiboly of the blastema, the fusion of its different poles, as a result of which the defect, gaping anteriorly and upward, receives a slit-like or closed oval, elliptical, ring-shaped or semilunar expansion in the form of a beak (corium). The development of hypospadias is caused, first of all, by a genomic mutation in the anterior third of the embryo (blastoderm), which occurs immediately after the formation of the primary blastodermal cavity, or compaction cleft. The appearance of G. is observed in the second or third week after fertilization, that is, in a two-cell embryo with an epithelial type of structure. There are primary and secondary G., which determine the size and localization of the renal fissure. Primary G. occurs in a hollow trunk along the anterior border of the blastocyst in the region of its proximal section (“hypertrophied”); G. is accompanied by erosion of the blastoma in the form of fascia-like formations on both sides of it, extending in the cranial and caudal directions, respectively. Thus, primary G. is, as it were, a stack of a whole series of primary cellular mutations. G., developing secondarily, is due to larger dimensions of the primary fissure in the early stages than for the primary type. Since the primary slit-like epithelial areas on both sides of the blastodere can reach large sizes during intrauterine development of humans