nizzah gus idk1 epispadias

7/25/2019 Nizzah Gus Idk1 Epispadias

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EPISPADIAS

N I Z Z A H A F I N A

1 3 1 0 2 1 1 0 1 1


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DEFINISI

Kelainan kongenital berupa tidak adanya dinding uretra bagian a

kelianan ini terjadi pada laki-laki maupun perempuan, tetapi leb

pada laki-laki, ditandai dengan terdapatnya lubang uretra di sua

pada permukaan dorsum penis. (Dorland)

Kelainan yg jarang dijumpai (1:30000) berupa ostium uretrae ek

ditemukan di dorsum penis. uberkulum genital tidak terbentuk kranial membrane kloakalis, tetapi terbentuk di region septum u

Karena itu, sebagian dari membrane kloakalis terdapat disebela

dari tuberkulum genital, dan ketika membrane ini pe!ah, muara

urogenitalis menjadi terletak di aspek kranial penis. "mumnya d

ekstro# kandung kemih. ( $angman)


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EPIDEMIOLOGI

%pispadias o!!urs more !ommonly in males than in &emales, 'it

prealen!e o& 1 !ase in 10,000-0,000 persons. he male-to-&em

*.3:1

(+eds!ape)


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CAUSES

he !auses o& epispadias are not kno'n. t may o!!ur be!ause t

bone does not deelop properly.

%pispadias !an o!!ur 'ith a rare birth de&e!t !alled bladder est

this birth de&e!t, the bladder is inside out and sti!ks through the

'all. %pispadias !an also o!!ur 'ith other birth de&e!ts.

he !ondition o!!urs more o&ten in boys than girls. t is most o&tdiagnosed at birth or soon a&ter'ard.

(". national library o& medi!ine)


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ETIOLOGY

"nlike hypospadias, epispadias !an be eplained by de&e!tie m

the paired primordia o& the genital tuber!le that &use on the mid

the genital tuber!le at the #&th 'eek o& embryologi! deelopme

%pispadias and estrophy o& the bladder are !onsidered arying

a single disorder.

/nother hypothesis relates the de&e!t to the abnormal deelopm

!loa!al membrane.

%pispadias is rarely obsered in * members o& the same &amily.

(+eds!ape)


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CLASSIFICATIONS

glandul

ar penile

peno

bi


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CLASSIFICATIONS

%pispadias ary in seerity a!!ording to the time o& the pathognomi! ins

embryologi! deelopment and !an be !lassi#ed as glandular, penile, or

penopubi!).

1. ith the glandular type, the mal&ormation ae!ts the distal part o& the

*. ith the penile type, the entire penile urethra is ae!ted, 'ith an eteon the dorsal sha&t o& the penis.

3. ith the !omplete or penopubi! type, a total de#!ien!y o& the dorsal urethra and the anterior 'all o& the bladder is present.

.he glans is o&ten spatulated, and the prepu!e is !le&ted dorsally 'ith e

transposition. /ll &orms o& epispadias are asso!iated 'ith !hordee. he e

!hordee aries.

. n &emales, epispadias !onsists o& bi#d !litoris 'ith diastases o& the !orp

!aernosa, 2attening o& the mons, and separation o& the labia.

(+eds!ape)


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SYMTOMPS

+ales 'ill hae a short, 'ide penis 'ith an abnormal !ure. he

most o&ten opens on the top or side o& the penis instead o& the t

o'eer, the urethra may be open along the 'hole length o& th

4emales hae an abnormal !litorus and labia. he urethral open

bet'een the !litoris and the labia, but it may be in the belly are

hae trouble !ontrolling urination (urinary in!ontinen!e)(". national library o& medi!ine)


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GEJALA KLINIS

idak terjadi sendirian, biasanya disertai anomaly saluran kemih

5enis pipih dan ke!il

+elengkung ke dorsal -6 urin ba!k'ard

nkontenensia urin


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EXAMS AND TEST

1. igns in!lude:

. /bnormal opening &rom the bladder ne!k to the area aboe the

urethra opening

. 7a!k'ard 2o' o& urine into the kidney (re2u nephropathy)

. "rinary in!ontinen!e

. "rinary tra!t in&e!tions

. idened pubi! bone



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*. ests may in!lude:

7lood test

ntraenous pyelogram (85), a spe!ial -ray o& the kidneys, blad

ureters

+9 and s!ans, depending on the !ondition

5eli! -ray

"ltrasound o& the urinary system and genitals



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TREATMENT

5atients 'ho hae more than a mild !ase o& epispadias 'ill need

$eakage o& urine (in!ontinen!e) !an o&ten be repaired at the sam

o'eer, a se!ond surgery may be needed.



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INDICATIONS

orre!tion o& glandular epispadias 'ith reposition o& the distal urethra and

symmetri! glans (glanuloplasty) is indi!ated in !hildhood or adoles!en!e at

re


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CONTRAINDICATIONS

"rethroplasty and restoring the normal appearan!e o& the genita

!ontraindi!ated in in&an!y be!ause o& the small si=e o& the stru!

(+eds!ape)


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OUTLOOK (PROGNOSIS)

urgery !an help the person !ontrol the 2o' o& urine. t 'ill also

appearan!e o& the genitals.



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POSSIBLE COMPLICATION

ome people 'ith this !ondition may !ontinue to hae urinary in

een a&ter surgery.

"reter and kidney damage and in&ertility may o!!ur.



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REFERENCES

>earhart ?5, +athe's 9. %strophy-epispadias !omple. n: ein /?, ed.>e

+athe's 9. %strophy-epispadias !omple. n: ein /?, ed. Campbell-Wals

10th ed. 5hiladelphia, 5/: aunders %lseier@ *011:!hap 1*A.

%lder ?. /nomalies o& the bladder. n: Kliegman 9+, 7ehrman 9%, ?enson

74, eds.%lder ?. /nomalies o& the bladder. n: Kliegman 9+, 7ehrman 9%, ?

tanton 74, eds. Nelson Textbook of Pediatrics.1Bth ed. 5hiladelphia, 5/:

%lseier@ *011:!hap 3. Update Date 1/12/2014

"pdated by: !ott +iller, +D, "rologist in priate pra!ti!e in /tlanta, >/. /

by Daid Ciee, +D, +/, 7ethanne 7la!k, and the /.D./.+. %ditorial team

+eds!ape

nizzah gus idk1 epispadias

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