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Hypospadias – Historical · PDF file Hypospadias – Historical Aspects A R MundyA.R.Mundy & D E AndrichD.E.Andrich Institute of Urology London

Aug 24, 2020

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  • Hypospadias – Historical AspectsAspects

    A R Mundy & D E AndrichA.R.Mundy & D.E.Andrich Institute of Urology

    London

  • What Is Hypospadias?What Is Hypospadias?

  • Not In AsiaNot In Asia

  • (Thiersch) Duplay(Thiersch) Duplay

  • Excellent Results Hendren (1980)Excellent Results – Hendren (1980)

  • Meatal SiteMeatal Site

  • Changing AttitudesChanging Attitudes

    WasWas • No real attention to the glans and meatus

    NowNow • Mainly attention to the glans and meatus

  • MAGPIMAGPI

  • MAGPIMAGPI

  • ‘S d ’ i l ill i‘Snodgrass’ - optical illusion

  • Unnecessary TraumaUnnecessary Trauma

  • Post Operative GeneralPost-Operative - General

  • Glans CleftGlans Cleft

  • Short UrethraShort Urethra

  • Deficient DartosDeficient Dartos

  • ????

  • The UrethraThe Urethra

  • What Makes It Difficult? 1What Makes It Difficult? - 1

    • Small glans • Traumatic soft tissue lossTraumatic soft tissue loss • No dartos • No spongiosum • Previous graft or flap requiring excision• Previous graft or flap requiring excision • Significant chordee • Stricture in previous urethroplasty >3cm • Associated lichen sclerosus• Associated lichen sclerosus

  • What Makes It Difficult? 2What Makes It Difficult? - 2

    • Small penis • Large fistula or multiple fistulaeLarge fistula or multiple fistulae • Scarred penile shaft • Associated bulbar stricture • Associated peno-scrotal transposition• Associated peno-scrotal transposition • Associated obesity

  • ProblemsProblems

    • How to test the listHow to test the list • How to quantify e.g. ‘small’, ‘deficient’ • How to score severity:

    – Groups of problems = Grade 1,2 or 3p p , – Score each problem 1,2 3 etc to give a total

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