Nursing 209

N209: Reproductive Health Study Guide o Often requires orthodontic care along with speech therapy

6.4 Genitourinary Defects Hypospadias • Occurs in the eighth to fourteenth week of pregnancy, with abnormal formation of the urethra, where the opening is below the end of the penis • Three types of hypospadias: o Subcoronal: Opening of urethra is near head of penis o Midshaft: Opening is located along the penile shaft o Penoscrotal: Opening is where the penis and scrotum meet • Also associated with chordee, where there is an abnormal curvature of the penis up or down where the head and shaft meet • May also have undescended testes • Occurs in 5:1000 boys in the U.S. • Increased incidence in mothers who are over 35 years old or obese, have had infertility treatment, or utilized hormonal treatment immediately prior to or during pregnancy • Diagnosis is made by physical exam • Treatment: Most cases require surgical correction o Circumcision is delayed, as foreskin is utilized for repair o Usually done between 3-18 months of age and may be done in stages depending upon associated problems Hydrocele • Fluid-filled sac surrounding a testicle that causes swelling in the scrotum • Types: o Non-communicating: Sac closes and normally fluid is reabsorbed; fluid remains after sac closes but is usually absorbed in the first year of life o Communicating: Sac remains open and fluid can flow back into the abdomen; often associated with inguinal hernia • Present at birth and occurs in 1-2% of newborns • Increased risk with prematurity • Treatment: If they do not resolve or they increase in size within one year, surgery is recommended

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