Congenital abnormal urethral opening on the dorsal aspect of the penis is known as:

Appeared in: RUHS, Jaipur, PB B.Sc Nursing Entrance-2020

Explanation

Epispadias is a congenital defect where the urethra opens on the upper surface (dorsum) of the penis.
This condition is a result of abnormal embryological development where the urethral plate does not close correctly.
It is distinct from the normal urethral opening, which is located at the tip of the glans penis.
Epispadias is often associated with a more severe condition called bladder exstrophy.

Option B: Hypospadias is an incorrect choice because it refers to the urethral opening being on the ventral (underside) of the penis, not the dorsal (upper) side.
Option C: Exstrophy of the bladder is a more extensive congenital anomaly where the bladder is turned inside out and protrudes through the abdominal wall. While it is commonly associated with epispadias, it is not the term for the urethral malposition itself.
Option D: Phimosis is a condition where the foreskin is too tight to be retracted over the glans penis. It does not involve an abnormal location of the urethral opening.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Congenital anomalies of the male genitourinary system as background academic context rather than a clinical decision trigger.
A key nursing responsibility is to advise parents of newborns with epispadias or hypospadias that the child should not be circumcised, as the foreskin is often used for surgical repair.
Post-surgical care involves meticulous monitoring of urinary output, catheter/stent care to ensure patency, and pain management to ensure proper healing.
Providing psychological support and clear education to the parents is crucial, as the diagnosis can be distressing.

How to Approach the Question

This is a factual recall question that tests knowledge of medical terminology for congenital anomalies.
First, identify the key descriptive terms in the question: 'congenital,' 'urethral opening,' and 'dorsal aspect of the penis.'
The term 'dorsal' is critical; it refers to the top or upper surface.
Recall the definitions of the options provided. 'Epi-' often relates to 'upon' or 'above,' while 'hypo-' relates to 'under' or 'below.'
Match the term 'dorsal aspect' (upper side) with Epispadias.
Differentiate this from Hypospadias (ventral/underside), Exstrophy (exposed bladder), and Phimosis (tight foreskin) to confirm the correct answer.

Concept Tested & Keywords

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E6 Text Book Of Pediatric Nursing 3rd Panchali Pal — Part 2 (pp 239-476 of 713) p. 194-196

E6 Nelson Textbook of Pediatrics(2024) — Volume 2 p. 1088-1090

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