Question

Describe 2 congenital anomalies of the penis

Answer 1

PHIMOSIS

A condition in which tight foreskin can't be pulled back over the head of the peni s.

Tight foreskin is normal in an uncircumcised child. It often goes away over time with regular, gentle retraction

Phimosis may appear as a rubber band of skin around the tip of the pen is. If complications develop such as bleeding or infection around the foreskin, or painful urination, a paediatric urologist should do an examination.

Treatment depends on severity

Treatment might include a steroid cream or removal of the foreskin (circumcision).

EPISPADIASIS

Epispadias is a rare congenital urological birth defect. In simple terms, epispadias is a condition that is present at birth and affects the urinary tract and alters the way urine exits the body. More common in boys than girls, epispadias appears in about one in 100,000 males and about one in 480,000 females.

Types

Epispadias can occur alone but is far more commonly present with one or more other conditions ranging from additional alterations in the way urine exits the body to more severe urological problems, bladder issues, pelvic floor problems, incomplete abdominal wall formation, or even an oddly located anus. This wide range of epispadias-related conditions is referred to as the exstrophy-epispadias complex

Types of Male Epispadias

The opening in the peni s where urine exits the body is called the urinary meatus. Normally, this opening is at the tip of the peni s, but in epispadias, this opening appears along the top of the peni s. Where along the top of the pen is the opening is found dictates the type of epispadias that is present.

Penopubic epispadias: This is where the urinary meatus is found close to the body, potentially not on the pe nis but near the pubic bone at the base of the pen is.

Pe nile epispadias: The urinary meatus is found on the shaft of the p enis, anywhere before the head of the pe nis but above the base where the shaft meets the body.

Glanular epispadias: This is where the urinary meatus is found on the head of the pen is, but on the top rather than in the standard location at the tip.

Symptoms

In many cases, epispadias is diagnosed by a healthcare provider at birth due to the abnormal appearance of the genitals in the newborn. In mild cases, where the urinary meatus is slightly out of normal position, the condition may be overlooked until there is difficulty with potty training or urinary incontinence that is noted after potty training is complete.

Some children will experience stress incontinence, where urine dribbles after a sneeze or cough, or may find that when they have the urge to urinate they are unable to hold it until they reach the bathroom. A genital examination is often part of the process of diagnosing the cause of incontinence and may lead to the diagnosis of epispadias.

Surgery

The risks of all surgeries include the general risks of surgery and the risks associated with the administration of general anesthesia. In the case of epispadias repair, the risks vary with the severity of the issue and the nature of the repair. In general, the risk of urinary incontinence is high, as many individuals already have this condition prior to surgery, and the hope is that surgery will fix the incontinence.

Urinary tract infections, fistulas, hypospadias and p enis injury are common risks. In individuals with bladder involvement, bladder stones and bladder perforations are additional risks.

For some male patients, the surgical correction for epispadias and urine coming out on the top of the pen is may lead to hypospadias, and urine coming out from the underside of the p enis after reconstruction has healed. This can be corrected, if necessary, and may or may not be a serious issue.