CONGENITAL ABNORMALITIES

OF GENITALIA MALE

Oleh :
Dr. Bakri B. Hasbulloh, SpB.FINACS

Bagian Bedah FK UMS- RSUD Kab.Karanganyar

Senin : 31 Oktober 2011
SURAKARTA

PATHOLOGY

OF DISEASE :
CONGENITAL
TRAUMA
INFECTION
DEGENERATIVE
/ METABOLISM
CANCER

SURGERY
INTERNIS
PEDIATRIC
OBGYNE / GYNECOLOGY
THT
SYARAF
KULIT KELAMIN
MATA
RADIOLOGY
PULMONOLOGY
RM
REPRODUCTIVE
Dll.

FERTILITY >< INFERTILITY :

CONGENITAL
COUPLE (PASANGAN SUAMI TRAUMA
ISTRI)
INFECTION
CINTA
ANAK
DEGENERATIVE
FERTILE
/ METABOLISM
INFERTILE :
AFTER MARRIED
CANCER

1-2 YEARS
NO CONTRACEPTION
NORMAL SEXUAL
NO BABY

INFERTILITY :
pre testiculer

Hipotalamus
hipofise

testiculer
testis

post testiculer

peni
s


Kelainan pada hipothalamus
Defesiensi LH, FSH atau GnRH
Kelainan pada hipofise
Insufisiensi hipofisis o/k tumor, radiasi,
operasi

Kelainan pada testiculer

Anomali Kromosom
Anorchismus bilateral
Gonadotoksin : menurunkan
spermatogenesis
Trauma testis
Penyakit sistemik sp DM. hipertensi dll
Varikokel
Kriptorchismus

Kelainan pasca testikuler

Gangguan transport sperma : CBAVD
Kel.fungsi dan tmotilitas sperma

EMBRYOLOGY OF HE MALE
EXTERNAL GENITALIA
NORMAL DEVELOPMENT :
AT THE END of 2 weeks of development 2 cell

layers :
The ectoderm

The Primitive Streak

The Entoderm
* The Cloacal Membran
* The Alantois
THE MESODERM
* The external genitalia and anus are formed by developments
about the cloacal membran and the allantois

Abnormalitities
HYPOSPADIAS AND

CHORDAE

The urethral meatus On the ventral surface of th shaft

of the penis
A layer of fibrous tissue CHORDAE

EPISPADIAS AND EXTROPHY

The urethral meatus On the dorsal surface of th shaft
of the penis
The membrane vesica urinaria defect EXTROPHY

Anatomi

Sistema reproduksi lakilaki

1.ORGAN
Testis :
Testosteron
Spermatozoa
Epididimis
Vasdeferens
Vesicula seminalis
Penis
2.PROSES
SPERMATOGENESIS
Tubulus
seminiferus
3.HORMON
Testosteron

HIPOSPADIA

Hipospadia anterior tipe

coronal

Masalah Hipospadia
CUASA :

MULTIFACTORIAL

Genetik
Hormonal
Ras dll

REPRODUKSI
Pancaran spermatozoa

SEKSUAL
Pain

UROLOGI

Stenosis
Stricture
Stone
ISK (infeksi saluran kencing)

URETHRA
LETAK DI
SEPANJANG PENIS,
BUKAN DI TOP
GLAND PENIS

PANCARAN
ABNORMAL

PENIS
MELENGKUNG DAN
PENDEK

TIPE HIPOSPADIA
Barcat

(1973) berdasarkan letak ostium urethra

eksterna terbagi 5 tipe :

Tipe gland
Part Anterior

65-70%
Tipe coronal
Tipe penil Part Penil 10-15%
Tipe penoscrotal
Part Posterior
20%
Tipe perineal

THERAPY

CHORDECTOMY
Merelease chordae Penis jadi lurus saat ereksi

URETHROPLASTY
Membuat Ostium urethra externumdi ujung penis

sehingga pancaran urin / sperma ke depan

4 Pertimbangan Pre Operative

1.

USIA

2.
3.
4.

Usia 6 bulan sampai usia sebelum sekolah

TIPE HIPOSPADIA
BESAR PENIS
ADA TIDAKNYA CHORDAE

BERHUBUNGAN
DENGAN ONE
STAGE OR TWO
STAGE OPERATIVE

COMPLICATION
AERLY

BLEEDING
INFECTION
OEDEMA

LATE
FISTULE URETHRACUTANEUS
REST CHORDAE
STRICTURE URETHRAE
STENOSIS URETHRAE
DIVERTICLE URETHRAE

PROGNOSIS

COMMONLY : BAIK

WASSALAAMUALAIKUM
WW