Be alert if the child does not urinate through the urinary tract located at the tip of the penis. It could be that he suffers from hypospadias.
Normally, children urinate through the urinary tract (urethra) which is at the tip of the glans (head) of the penis. Well, in some children, they urinate not through this location but through the hole at the bottom of the penis. This is a disorder called hypospadias. (if the urethra is above the shaft of the penis it is called epispadias)
WHAT IS HYPOSPADIA?
Hypospadias is a case where urine does not come out through the urethral opening in the glans penis but through a hole at the bottom of the penis shaft, at the base of the penis it even goes through the scrotum (scrotum). That's why the sianak doesn't urinate as usual but instead pours it out the way the upik urinates.
This case occurs differently in each country, ranging from 1-8 out of 1000 births. In Indonesia itself, the incidence rate is not yet known with certainty. Currently there is a tendency to increase the incidence of hypospadias due to increased consumption of hormone preparations by mothers. The exact cause of this disorder is still unclear, but there are several factors that are known to play an important role. Among them are hereditary factors, 8% of fathers of children with hypospadias also experience the same thing. Men who have a history of their testicles not descending into their sacs (cryptorchidism) have a greater risk of having a son with hypospadias. The mother's age at birth also has an influence, the incidence of hypospadias is 50% higher for mothers aged >35 years than for those aged <20 years="" mothers="" who="" receive="" estrogen="" hormone="" therapy="" during="" pregnancy="" have="" a="" high="" risk="" of="" suffering="" from="" hypospadias="" test="" tube="" babies="" also="" greater="" experiencing="" this="" disorder="" environmental="" factors="" play="" role="" including="" substances="" that="" activity="" such="" as="" the="" namely="" phytoestrogens="" found="" in="" soybeans="" birth="" control="" pills="" pesticides="" detergents="" plastic="" making="" materials="" apart="" which="" act="" anti-androgens="" an="" effect="" anti-fungal="" are="" widely="" used="" to="" protect="" vegetables="" and="" fruit="" another="" characteristic="" sufferers="" is="" their="" penis="" looks="" bent="" caused="" by="" appearance="" connective="" tissue="" at="" bottom="" serious="" problem="" must="" be="" addressed="" immediately="" if="" you="" leave="" it="" until="" your="" child="" adult="" he="" might="" difficulty="" having="" husband="" wife="" relationship="" currently="" way="" treat="" surgery="" p="">
Types of hypospadias are differentiated based on the location of the urinary tract opening. The light type (distal type) is the one whose hole is located near the tip of the penis, the medium one (Mid type) is the hole in the shaft of the penis, while the heavy type (proximal type) is the one whose hole is at the base of the penis, scrotum, even in the groin . Some hypospadias are of the distal type. The further back the hole is located (proximal type), the more difficult it is to handle.
There are many surgical techniques for repairing hypospadias, but basically the goal to be achieved is a penis that can function both as a reproductive and urinary tool and whose shape is cosmetically similar to the shape of a normal penis. The operation can be carried out in 1 stage or several stages, depending on the severity of the case. The latest surgical techniques allow most hypospadias to be repaired in 1 stage. If the case is mild, such as the urinary hole in the shaft of the penis, surgery will only create an artificial urinary tract in the penis. But if connective tissue appears, the operation will be carried out in two stages. The first stage is to remove the connective tissue, then the next stage is surgery on the penis to create an artificial urinary tract.
SURGERY AT EARLY AGE
Because the characteristics of hypospadias are very clear, namely that urine does not come out in the right channel, treatment can be done when the child is 18-24 months old. Why so early? This is to anticipate if the operation needs to be carried out in several stages, so before the child goes to school it is hoped that the hypospadias will have been repaired, besides that the size of the penis will be large enough so that it will be easier to carry out the operation. For patients with a penis that is too small, hormone stimulation therapy can be performed beforehand. Apart from that, surgery at an early age also avoids physical and psychological problems that occur when the child reaches school age. Psychological problems, of course children are embarrassed if they don't urinate standing up. Physical problems, of course this is related to reproductive function in the future. A normal urinary tract will allow sperm released during ejaculation to enter the vagina. Just imagine if sperm were still produced but came out through the urethra which is located under the shaft of the penis? It's a hassle, right?
There is no need to worry about such a small child having surgery because the operation is simple.
Article written by dr. Johan Wibowo, Sp.U (Urological Surgery Specialist at EMC Pulomas Hospital).