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  • 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

    (". national library o& medi!ine)

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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

    (". national library o& medi!ine)

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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.

    (". national library o& medi!ine)

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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.

    (". national library o& medi!ine)

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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.

    (". national library o& medi!ine)

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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 %[email protected] *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/:

    %[email protected] *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