DIFFERENTIATING NORMAL PENIS OR HIPOSPADIA

AND HIS HANDLING

By :
Aji Purnomo
Stikes Widyagama Husada
Malang

Mortalitas and of morbiditas at baby at the moment still very high at natural
baby of disease of wafting, one of the because morbiditas at baby is Hipospadia.
Hipospadia is disparity of wafting in the form of hole of urethra which located in
underside of[is near by penis jetty. Hipospadia represent disparity of wafting that
happened at 3 among 1.000 newborn baby.
Hipospadia is one of the disparity of wafting at children which is often found
and easy to him, only its must be done by them which really expert so that get
satisfying result. In Indonesia, although there is no data of PJB accurate, but the
problem of clear PJB have needed attention which seriously either from medical
doctor and also specialist. Therefore, pandemic knowledge of hipospadia very
needed to treatment student in supporting interest standart education of nurse,
which where this matter is required to know, and comprehend and also can explain
congeniality of hipospadia, etiology, symptom sign of hipospadia, and handling of
hipospadia.
Etymologically Hipospadia come from two word that is " hypo" meaning "
below/under" and " spadon" meaning long counterfoil, theoretically hipospadia
represent a[n abnormal situation of growth of urethra of anterior where urethra
meatus of eksternal located in part of ventral and situation more proksimal of
normal situation and accompanied by the existence of firosis at part of MUE distal
which cause to curve penis him (chordae), later then a theory lay open this disparity
because of premature stop of growth of cells producer of androgen in testis, so that
produce androgen desisted and result inkomplit maskulinisasi of external genitals.
This process cause trouble forming of ureter (urethra), so that this channel can tip
of wherever as long as penis diameter depended moment the happening of trouble
of hormonal. Progressively early the happening of trouble of hormonal, hence
abnormal urine hole of estuary will progressively closed to jetty.
 Most child with disparity of hipospadia have tortous penis bar form. Usually
around the abnormal urine hole formed by network fasten (fibrosis) having the
character of to draw and wrinkle vinicity husk. If seen from from other sideing,
visible penis arch like fan (chordee, Latin Ianguage); specificly network grat around
ureter estuary is later;then referred as by chordee. Do not each;every hipospadia
have chordee. Oftentimes boy with hipospadia also have disparity in the form of
testis which not yet got down to to its privy parts poke (testis undescended).
Hipospadia have some classification pursuant to situation of orifisium urethra of
eksternum/meatus that is for example Simple type hipospadia/type of Anterior
which where Located in anterior which consist of type of glandular and of coronal.
At this type, teletak meatus at jetty of glands penis. By klinis, this disparity have the
character of asimtomatik and do not need a[n action. If meatus rather narrow;tight
can be done/conducted by or dilatation of meatotomi, later;then Type of penil /
Type of Middle which consist of penile distal, penile proksimal, and pene-escrotal.
At this type, located meatus between penis glands and of scrotum. Is usually
accompanied with disparity of penyerta, that is husk inexistence of prepusium part
of ventral, so that penis seen to arch downwards or penis glands become pipih. At
disparity of this type, is needed by action intervention operate on step by step,
considering husk in part of prepusium ventral there no hence better at baby do not
be done/conducted by sirkumsisi because rest of existing husk can good for action
operate on hereinafter, last later;then that is Type of Posterior which consist of type
of scrotal and of perineal. At this type, its it him growth of penis will annoyed, is
sometime accompanied with bifida scrotum, wide open urethra meatus and
generally testis do not go down
Hipospadia represent a disease able to because of some dominant factor that is
Trouble and imbalance of hormone, such of such hormomone here is androgen
hormone arranging kelamin organogenesis (man), later;then factor of Genetika that
happened because failing of androgen sintesis. This matter usually happened
because mutation at gene which is code of sintesis the androgen so that expression
of the gene do not happened, hereinafter is Environment becoming cause is Iihat
vitamin and polutan having the character of teratogenik able to result mutation.
Marking from the happening of disease of this hipospadia is Situation urine hole
which still in penis head usually seldom generate sigh to patient at children age.
Sigh will arise at heavier disparity and at older patient age.
Heavier disparity which generate sigh, for example urine hole situation which
progressively up at penis jetty and/or existence of tortous penis form. If disparity
this form of do not improve;repair with operation action, patient later will
experience of function trouble of berkemih in the form of radiation and direction of
urine which below par. In the situation which is very weight, patient even cannot
urine in position stand up because exit urin seep so that patient will be more be
balmy in position cringe. Problem of arising out will be complicated progressively
in parallel increasing patient age him. Psychological problem arise effect of penis
form which below par and habit of atypical berkemih like normal boy which
coeval. At age of pascapubertas and at usiareproduksi, patient will experience of the
problem of function reproduce with reference to tortous penis form of erection
moment, difficulty of penetration of penis of moment correlate radiation trouble
and body of ejakulasi.
Till in this time Cause of hipospadia till now not yet earned to surely, but theorys
expanding generally hook;correlate this disparity with problem of hormonal, but for
its handling can be conducted by operation. This operation by self aim to to
reconstruct penis so that diametrical with urethra orifisium at normal place or
laboured to as normal as possible. Operation better be executed at the (time) of
child age that is six-month until age of prasekolah. This matter is meant that at this
age of child expected by not yet is conscious is that he so is " special", and differ
from its other friends that is where other child usually miksi (piss) by standing
while he self have to do it cringed urin aga do not " mbleber" to many places. Child
which suffering hipospadia shall don't first dikhitan, this matter relate to operation
action reconstruct to take husk of preputium penis for hole plug of urethra sulcus
which do not one at patient of hipospadia, correct handling to child suffering from
this is hipospadia very is required, this matter because of to be handling can be
conducted real correctly so that hipospadia can be prevented early possible