Pediatric Surgery Hypospadius 2 urethroplasty

Urethroplasty

Procedure

1.  Hold the glans with a silk stay suture.

2.  Mark the incision with a marking ink or pen.

3.  Make a ‘U’ shape incision on the ventral surface of the penis around the meatus.

4.  Roll it into a tube over a # 6 feeding tube.

5.  Make the water tight urethra with PDS.

6.  Approximate subcutaneous tissue with catgut.

7.  Close skin with interrupted nylon suture.

8.  Apply compression penile dressing.

Options

1.  Single stage urethroplasty, if no chordee.

2.  Multistage procedures, if associated with:

     •   Chordee

     •   Torsion of phallus.

Instruments

General Pediatric Surgical Set

Special instruments

•   Fine scissors                                      1 (Fig. 21.4)

•   Fine tissue forceps                           2 (Fig. 21.5)

•   Skin hooks                                        2

•   Measuring scale                                1

•   Marking ink/pen                               1

•   Silastic/PVC catheter                        # 6, 8

Sutures

•   5/0 PDS/Dexon                                 1

•   5/0 Catgut                                         1

•   4/0 Silk                                               1

•   5/0 Nylon                                           1

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Pediatric surgery Hypospadias 1 cordee correction

Hypospadias

Definition

In cases of developmental defect of urethra, leading to position­ing of the urinary meatus proximally on the ventral surface of penis and also resulting in:

•   Distortion of the penis (chordee) 

•   Misdirected urinary stream 

•   Possible difficulty in reproductive functions later.

Objectives

•   To correct chordee if present 

•   Reconstruction of urethra from opening to tip.

Position

Supine.

Anesthesia

General with endotracheal intubation.

Chordee Correction

Procedure

1.  Hold the glans with stay sutures.

2.  Inject normal saline in glans to check chordee.

3.  Excise the fibrous cord, if any.

4.  Readjust the prepuce on the ventral surface.

5.  Advance the prepucial skin to the edges of the navicular fossa.

6.  Close the wound in 2 layers.

7.  Drain the bladder with a urethral catheter

Any questions be sent to drmmkapur@gmail.com  

All older posts are stored in archive for accessand reiew

Thosewho follow may post contributions to the site,please writo tp address above.

To create consumer/provider enagement visit www.surginstruatlas.blogspot.com 

www.drmmkapur.blogspot.com                   www.surgseminar.blogspot.com  

Also available now on android & smartphones same internet address

Complete set of blogs & precepts available at distance  learning support Tryselfcare.