DIAGNOSIS AND SURGICAL TREATMENT OF HYPOSPADIA IN GIRLS
- Authors: Soloviev A.E1
-
Affiliations:
- Ryazan State Medical University
- Issue: No 2 (2021)
- Pages: 78-81
- Section: Articles
- URL: https://journals.eco-vector.com/1728-2985/article/view/312565
- DOI: https://doi.org/10.18565/urology.2021.2.78-81
- ID: 312565
Cite item
Abstract
Aim. To suggest new method of surgical correction of hypospadias in girls. Materials and Methods. For 50 years under our supervision there were 220 girls diagnosed with hypospadias of various forms. In the diagnosis used anamnesis, examination, catheterization and cystoscopy of the bladder, vaginoscopy, ultrasound and X-ray research methods. Results and Discussion. Of 220 girls with a diagnosis of hypospadias, vestibular (partial) hypospadias occurred in 201 girls, vestibulovaginal (subtotal) in 16, and vaginal (total) in 3. Of 201 girls with vestibular hypospadias, 37 suffered from urinary incontinence, 16 had vesicoureteral reflux, 21 had doubling, 5 had renal hypoplasia, and 12 had renal dystopia. The vulvovaginal form was manifested not only by the dystopia of the external opening of the urethra, but also combined with the underdevelopment of the sphincteral apparatus of the bladder. All children had daytime and nighttime urinary incontinence, vulvovaginitis. Cystoscopy revealed hyperemia of the urethra and bladder neck. X-ray urological examination revealed VUR in 6 children, ureterohydronephrosis - in 2. All children suffered from chronic pyelonephritis, 8 - day and night urinary incontinence. There were 3 girls (14-16 years old) with vaginal (total) hypospadias. All suffered from constant urinary incontinence, vulvovaginitis, cystitis, chronic pyelonephritis, all had VUR. The new operation for the vaginal (total) form ofhypospadias, proposed by us, restores the closure function of the bladder sphincter by suturing the defect in the posterior wall of the bladder neck. Conclusion. Hypospadias is rare in girls. There are vestibular, vestibulovaginal and vaginal forms of hypospadias. In most cases, the vestibular form does not require surgical treatment. With the vestibulovaginal and vaginal (total) form of hypospadias, surgical treatment is indicated.
Keywords
Full Text
![Restricted Access](https://journals.eco-vector.com/lib/pkp/templates/images/icons/text_lock.png)
About the authors
A. E Soloviev
Ryazan State Medical University
Email: beerzombie@rambler.ru
Doctor of Medical Sciences, Professor, Head of the Department of Pediatric Surgery Ryazan, Russia
References
- Beleza-MeirelesA., Töhönen V., Söderhäll C., Schwentner Ch., Radmayr Ch., Kockum I., Nordenskjöld A. Activating transcription factor 3: a hormone responsive gene in the etiology of hypospadias. Eur J Endocrinol. 2008;158(5):729-739. doi: 10.1530/EJE-07-0793.
- Рудин Ю.Э., Марухненко Д.В., Гарманова Т.Н. Гипоспадия у женщин и девочек: обзор литературы и клинический случай. Экспериментальная и клиническая урология. 2015;(4):110-114.
- Kalfa N., Cassorla F., Audran F., Oulad Ahdennabi I., Philibert P., Béroud C., et al. Polymorphisms of MAMLD1 gene in hypospadias. J Pediatr Urol. 2011;7(6):585-591. doi: 10.1016/j.jpurol.2011.09.005.
- Kojima Y., Kohri K., Hayashi Y. Genetic pathway of external genitalia formation and molecular etiology of hypospadias. J Pediatric Urol. 2010;6(4):346-354. doi: 10.1016/j.jpurol.2009.11.007.
- Урология: национальное руководство / под ред. Н.А. Лопаткина. М.: ГЭОТАР-Медиа, 2009. 1024 с.
- Van der Zanden L.F.M., van Rooij I.A.L.M., Feitz W.F.J., Vermeulen S.H.H.M., Kiemeney L.A.L.M., Knoers N.V.A.M., Roeleveld N., Franke B. Genetics ofhypospadias: are single-nucleotide polymorphisms in SRD5A2, ESR1, ESR2, and ATF3 really associated with the malformation? J Clin Endocrinol Metab. 2010;95(5):2384-2390. doi: 10.1210/jc.2009-2101.
- Piaggio L.A. Congenital Adrenal Hyperplasia: Review from a Surgeon’s Perspective in the Beginning of the Twenty-First Century. Front Pediatr. 2014;1:50. doi: 10.3389/fped.2013.00050.
- Савченко Н.Е. Урология для общепрактикующего врача: справочное пособие. Минск: Белорусская навука, 1999. 271 с.
- Mouriquand P.D.E., Demède D., Gorduza D., Mure P.-Y. Hypospadias. In: Pediatric Urology. 2010. Ch. 41. P. 526-543. doi: 10.1016/b978-1-4160-3204-5.00041-4.
- Резник М.И., Шеффер Э.Дж. Урология. 68 случаев из практики / пер. с англ. М.: БИНОМ; СПб.: Невский диалект, 2002. 264 с.
- Гончар Н.Я, Подлужный Г.А. Повторные реконструктивные операции по поводу гипоспадии. Урология и нефрология. 1983;3:26-28.
- Liu В., Wang Z., Lin G., Agras K., Ebbers M., Willingham E., Baskin L.S. Activating transcription factor 3 is up-regulated in patients with hypospadias. Pediatr Res. 2005;58(6): 1280-1283. doi: 10.1203/01. pdr.0000187796.28007.2d.
- Аникеев А.В., Калинченко Н.Ю., Володько Е.А., Бровин Д.Н., Окулов А.Б., Безлепкина О.Б. Ранняя коррекция гипоспадии у девочки с нарушением формирования пола. Урология. 2019;(4):91- 94. doi: 10.18565/urology.2019.4:91-94.
- Соловьев А.Е. Патент на изобретение SU № 1597178. Способ лечения недержания мочи при тотальной женской гипоспадии. Выдано 08.07.1990 Гос. ком. СССР по делам изобретений и открытий.
- Gvozdev M.Yu., Loran O.B., Gumin L.M., D’yakov V.V. Distal urethral transposition in the surgical treatment of recurrent lower urinary tract infections in women. Urologiia. 2000;(3):24-27.
- Wein A.J., Kavoussi L.R., Partin A.W., Peters C.A. Campbell-Walsh Urology. 11th ed. Philadelphia, PA: Elsevier/Saunders; 2016. Vol. 1-4.
- Николаев В.В., Солонцов Ю.А. Эпидемиология и теория происхождения гипоспадии. Урология. 2018;(3):141-145. doi: 10.18565/urology.2018.3.141-145.
- Кан Д.В. Руководство по акушерской и гинекологической урологии. 2-е изд. M., 1986. 220 с.
- Hayashi G.Y., Carvalho D.F., de Miranda M.C., Faure C., Vallejos C., Brito V.N., de Santi Rodrigues A., Madureira G., Mendonca B.B., Bachega T.A.S.S. Neonatal 17-hydroxyprogesterone levels adjusted according to age at sample collection and birthweight improve the efficacy of congenital adrenal hyperplasia newborn screening. Clin Endocrinol. 2017;86(4):480- 487. doi: 10.1111/cen.13292.
- Маматкулов Б.М., Авезова Г.С. Врожденные аномалии как причина детской инвалидности. Наука молодых (Eruditio Juvenium). 2015;(2):110-115.
- Савченко Н.Е., Державин В.М. Эписпадия. Минск. 1976;58-71
Supplementary files
![](/img/style/loading.gif)