Liječenje hipospadija u djece

master's thesis

• Title (english): Hypospadias treatment in children
• Author: Matej Miloš
• Mentor: Tomislav Luetić (mentor)
• Committee member: Anko Antabak (predsjednik povjerenstva)
• Committee member: Tomislav Meštrović (član povjerenstva)
• Committee member: Tomislav Luetić (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Surgery); Zagreb
• Defense date and country: 2016-07-15, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Surgery

Abstract

Hipospadija je najčešća razvojna anomalija urogenitalnog sustava kod muškog spola.
Dok se kod normalno razvijene uretre njeno ušće nalazi na vrhu glavića, kod hipospadije ušće može biti na bilo kojoj visini sa ventralne strane penisa, skrotuma ili na perineumu i često je udruženo sa ventralnom zakrivljenošću penisa (chorda) i grbastim prepucijem koji je nedostatan na ventralnoj strani. Etiologija hipospadija se tumači teorijama nedostatne hormonske stimulacije penisa, genetskim poremećajima i posljedično vaskularnim anomalijama. Liječenje je isključivo kirurško, s ciljem rekonstrukcije funkcionalne uretre sa ušćem na vrhu glavića, postižući pritom ravan, proporcionalan i zadovoljavajući estetski izgled penisa.
Velika varijabilnost kliničkog fenotipa hipospadija čini liječenje uvijek ponovno izazovnim. To je tijekom vremena rezultiralo razvojem brojnih kirurških tehnika njihovog liječenja. Unatoč velikom broju operacija, učestalost je komplikacija nažalost vrlo visoka. U radu se opisuju novi koncepti i operativne tehnike s ciljem boljeg razumijevanja malformacije i njenog liječenja.
Posljedično razvoju modernih kirurških materijala i poboljšanjem kirurške tehnike značajno se smanjio i broj komplikacija. Usprkos tome procijene ishoda liječenja i zadovoljstvo bolesnika ostavljaju još puno prostora za potrebna poboljšanja na ovom području dječje urologije.

Abstract (english)

Hypospadia is the most common anomaly of the urogenital system among males. Normally developed urethra opens on the tip of glans penis, while in hypospadia urethral meatus is ectopically positioned and lies proximal to the normal site. The opening can be located even at the level of the scrotum and perineum. An affected penis can also have some degree of curvature called chordee and dorsal hooded prepuce. The etiology of hypospadias is interpreted with lacking of hormonal stimulation of the penis, genetic disorders and consequently vascular anomalies. Treatment is exclusively surgical, with the aim of functional urethral reconstruction with urethral meatus at the top of the glans and a straight, proportional and satisfying aesthetic appearance of the penis.
The large variability of the clinical phenotypes makes treatment challenging. It has over time resulted in the development of numerous surgical techniques of their treatment. Despite the large number of operations, incidence of complications is unfortunately very high. This paper presents new concepts and operational techniques for better understanding of the malformation and its treatment.
Consequently to the development of modern surgical materials and improved surgical techniques the number of complications is significantly reduced. Nevertheless, evaluation of treatment outcomes and patient satisfaction, are still leaving room for further improvement in this area of paediatric urology.

• Keywords: hipospadija; djeca; tehnike kirurškog liječenja; komplikacije
• Keywords (english): hypospadia; children; techniques of surgical treatment; complications
• Language: croatian
• URN:NBN: urn:nbn:hr:105:890661
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2017-07-03 09:34:30