Prenatal Diagnosis of Penoscrotal Hypospadia in Third Trimester by Two- and Three-Dimensional Ultrasonography: A Case Report

Rios, Lívia Teresa Moreira; Júnior, Edward Araujo; Nardozza, Luciano Marcondes Machado; Rôlo, Líliam Cristine; Hatanaka, Alan Roberto; Martins, Marília da Glória

doi:10.1155/2012/142814

Cited by 4 publications

(4 citation statements)

References 9 publications

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“…However, it is important to note that even during the second trimester, it is a challenge to distinguish between typical female anatomy and severe penoscrotal hypospadias with ultrasonography [2]. Three dimensional ultrasonography is recommended to confirm diagnosis in these cases [1]. …”

Section: Discussionmentioning

confidence: 99%

“…Position of the opening can change from the typical anatomical location within the glans penis to a subcoronal position (Type I), to anywhere along the ventral shaft (Type II), to penoscrotal, scrotal, or perineal positions (Type III). This urogenital condition is often diagnosed at birth, even though three dimensional ultrasound is able to detect it in-utero by the end of the second trimester [1–2]. …”

Section: Introductionmentioning

confidence: 99%

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Age of the Mother as a Risk Factor and Timing of Hypospadias Repair According to Severity

Jorge¹,

Perez-Brayfield

Torres

et al. 2016

JURNOA

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Background & Objectives Hypospadias is characterized by a displacement of the urethral opening in males that can change from the typical position within the glans penis to a subcoronal position (Type I), to anywhere along the ventral shaft (Type II), to penoscrotal, scrotal, or perineal positions (Type III). We and others have previously reported that age of the mother (≥ 40 years old) is a risk factor for having a child with hypospadias, but there is a scarcity of reports on whether such risk is higher for having a child with the mild (Type I) or the more severe forms (Types II and III). In addition, we aimed to assess the timing of hypospadias repair according to severity. Methods Parents of children with hypospadias were interviewed by using a series of questionnaires (n = 128 cases). Severity was confirmed in the clinic and age of the mother was self-reported. Number of surgeries, age of child by the first and the last intervention was also assessed. Ordered logistic regression and the Brant test were employed to calculate risk between mild (Type I) and severe cases (Types II and III), and the assumption of proportional odds, respectively. The Mann-Whitney U Test was used to compare number of surgeries and age by the last repair between mild and severe cases. One-way ANOVA was employed to compare age of the child at the time of first surgery across severities (Types I - III). Results Women ≥ 40 years of age are 3.89 times [95% CI: 1.20-12.64] at a higher risk for having a child with the more severe forms of the condition than younger women. Repair of Type I was accomplished with 1 intervention whereas more severe cases required 1 – 4 (2 ± 0.5) surgical interventions. The timing for hypospadias repair of Type I cases occurred at an average age of 16.2 ± 4.88 months, of Type II cases occurred at an average age of 20.3 ± 8.15 months whereas the average age of the first hypospadias repair among Type III cases was 12.68 ± 2.52 months. Number of surgeries according to severity (p ≤ 0.0018, z-ratio = 2.91) and age difference for the timing of last repair (p ≤ 0.045, z-ratio = 1.69) were statistically different, but not the age difference for the first repair. Conclusions Increased maternal age is associated with the most severe forms of hypospadias. There is room for improvement for the timing of hypospadias repair according to severity.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Age of the Mother as a Risk Factor and Timing of Hypospadias Repair According to Severity

Jorge¹,

Perez-Brayfield

Torres

et al. 2016

JURNOA

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“…Also, only one case report could be found about "tulip sign" and prenatal diagnosis of hypospadias by ultrasonography in the literature. 14 The most probable reason for this is that ultrasonography of genitalia include sex determination but not anomaly detection. According to Devesa et al 6 ; the purpose of prenatal evaluation of external genitalia should not be only to determine the sex, but also to detect anomalies.…”

Section: Discussionmentioning

confidence: 99%

Prenatal Diagnosis of Isolated Hypospadias by Using “Tulip Sign” with Two and Three-Dimensional Ultrasonography

Gürel

2016

Gynecol Obstet Reprod Med

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<p>Hypospadias is an anomaly of the male urogenital tract which occurs as a result of deficient closure of the urethral groove. Hypospadias is the most commonly seen urogenital anomaly in male neonates, but it is rarely diagnosed during prenatal period. Herein, a severe hypospadias case which was diagnosed by using 2D (two-dimensional) and 3D (three-dimensional) ultrasonography at 28 weeks of pregnancy with the aid of “tulip sign” finding was presented. 2D ultrasonography of 29 year old, primigravid woman at 28 weeks of gestation revealed an incurved, short penis with blunt tip located between the two scrotal folds and there was no additional anomaly. Findings were compatible with the “tulip sign” and case was diagnosed as isolated hypospadias. Isolated hypospadias was confirmed after delivery and surgical correction was planned. Prenatal diagnosis of hypospadias and relevant literature has been reviewed.</p>

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“…En cuanto a otras técnicas de imagen que se pueden utilizar, se mencionan en la literatura la ecografía 3D y la resonancia magnética (RM) [23][24][25][26] . La evaluación de Figura 3.…”

Section: B Aunclassified

Hipospadias: del diagnóstico ecográfico prenatal al manejo posnatal

Corrales-Sánchez¹,

Gallardo-Carvajal²,

Borenstein-Guelman³

2024

RECHOG

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El hipospadias es la localización anormal del meato urinario y es la malformación de genitales externos más frecuentemente diagnosticada. El diagnóstico prenatal es posible mediante ecografía sistemática desde la semana 20 de gestación, siendo más fácil su diagnóstico en el tercer trimestre. Las formas leves suelen ser aisladas, familiares o asociadas a disfunción placentaria o restricción de crecimiento intrauterino, mientras que las formas más graves presentan hasta un 30% de asociación a defectos fetales, anomalías cromosómicas/genéticas o anomalías del desarrollo sexual. La tríada para el diagnóstico ecográfico prenatal consiste en curvatura ventral del pene, anomalía del prepucio dorsal y punta del pene roma. La valoración de la uretra durante la micción y el aspecto del chorro miccional son de gran utilidad para clasificar el defecto. Cuando se diagnostica hipospadias peneano o escrotal es aconsejable realizar una amniocentesis para estudio genético fetal y valorar otros signos de adecuada virilización, como el descenso testicular a partir de la semana 27. El seguimiento tras el parto debe ser multidisciplinario, incluyendo urólogo y endocrinólogo infantil. En hipospadias leves el pronóstico es bueno con reparación quirúrgica en el primer año de vida, pero las formas graves pueden presentar un reto mayor para su corrección funcional y estética.

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Prenatal Diagnosis of Penoscrotal Hypospadia in Third Trimester by Two- and Three-Dimensional Ultrasonography: A Case Report

Cited by 4 publications

References 9 publications

Age of the Mother as a Risk Factor and Timing of Hypospadias Repair According to Severity

Age of the Mother as a Risk Factor and Timing of Hypospadias Repair According to Severity

Prenatal Diagnosis of Isolated Hypospadias by Using “Tulip Sign” with Two and Three-Dimensional Ultrasonography

Hipospadias: del diagnóstico ecográfico prenatal al manejo posnatal

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