Evaluation of Additional Anomalies in Concomitance of Hypospadias and Undescended Testes

Abstract

Objective: Hypospadias is a common genitourinary system (GUS) anomaly in boys occurring in 1 of 200 to 300 live births. Undescended testes is frequently detected among accompanying anomalies in cases with hypospadias. Especially in proximal hypospadias and bilateral cases, this association may indicate sexual differentiation disorders. The aim of the study was to evaluate the togetherness of additional anomalies in hypospadiac children with undescended testes. Material and Methods: Between 2007 and 2016, data of 392 children who underwent surgery for hypospadias were evaluated retrospectively. Urethral meatus was present at scrotal and penoscrotal in 65 cases (16.6%) and glanular, coronal, subcoronal and midpenile in 327 cases (83.4%). The cases were divided into two groups as those with both testes in the scrotum and those with undescended testes, and the anomalies were recorded. Results: The mean age of the children with proximal hypospadias was 21 months (6-240 months). Of the children with proximal hypospadias, 26 (40%) had undescended testes and 39 (60%) had testes in the scrotum. Undescended testes were detected bilaterally in 17 patients (65.4%) and unilaterally in nine patients (34.6%) in the undescended testes group. In the undescended testes group, 24 patients (92.3%) had suspected external genitalia (bifid scrotum, penoscrotal transposition, togetherness of micropenis and penoscrotal hypospadias, scrotalized labium majus) on physical examination. In the undescended testes group, three patients (11.5%) had additional urinary pathology and ten patients (38.5%) had other system anomalies. Ten patients (25.5%) had suspicious external genitalia on physical examination in the proximal hypospadias group who had both testes in scrotum. Additional urinary pathology was detected in one patient (2.5%) while other system anomalies were detected in five (12.8%) patients. The mean age of children with distal hypospadias was 33 months (6-156 months). Nine of 327 children with distal hypospadias (2.8%) had undescended testes. Of these, five were bilateral (55.6%) and 4 had unilateral undescended testes (44.4%). None of the patients with distal hypospadias had any suspicious genitalia on physical examination. In the undescended testes group, one patient (11.1%) had additional urinary pathology and one patient had other system anomaly. Seven patients (2.2%) who had both testes in scrotum had additional urinary pathology and 32 patients (9.8%) had other system anomalies. Conclusion: According to our results, further tests such as genitourinary ultrasonography, pelvic MRI if necessary, endocrine and genetic evaluation should be considered in cases where the proximal hypospadias is accompanied by an undescended testicle, and detailed anamnesis and physical examination covering all systems is necessary in all hypospadiac children in terms of additional anomalies.

Comparison Of Snodgrass and Bracka Methods In Terms Of Urethral Fıstula and Meatal Stenosis In Hypospadias Repair

“…Its etiology is multifactorial; main factors are advanced age, some chemical agents and drugs, cigarette, heredity (history of father's urologic disease), low birth weight, prematurity, small gestational age (SGA) and multiple pregnancy (3,4). As well as seemed to be isolated, hypospadias may be accompanied by antenatal hydronephrosis, urinary stones, neurological anomalies, other system anomalies and especially undescended testicle and inguinal hernia (5). Generally, as location, glanular hypospadias is the most frequently encountered localization.…”