Prenatal Diagnosis of Severe Hypospadias With Two- and Three-dimensional Sonography

Prenatal diagnosis of penoscrotal hypospadias and review of the literature

“…The cause of hypospadias is most likely a combination of monogenic and multifactorial forms, involving both genetic and environmental factors. [1][2][3][4][5][6][7] In addition to the determination of fetal sex, the detection of external genitalia anomalies has become an integral component of second trimester anomaly scans. The conventional sonographic criteria for the diagnosis of hypospadia is a small, "blunt-ended" penis with two echogenic lines at the tip, which represent the prepuce lateral folds.…”

“…Because there is improved visualization of the external genitalia at the third trimester, the prenatal diagnosis of hypospadias is not usually made until then. [2][3][4][5][6][7] Here, we report a successful case of the prenatal diagnosis of a penoscrotal hypospadia in the early second trimester of pregnancy. …”

3D, Vocal and Tomographic Ultrasound Image in Prenatal Diagnosis of Hypospadias

“…As previously described, 3,4 TUI mode was specially useful, its tomographic cuts and the manipulation of the ecographic angles were perfect to clearly show the curve and size of the defect (Fig. 3).…”

“…5 In fact, 3D US has allowed an accurate differential diagnosis in complex cases in female fetuses. 3 Moreover, sometimes fusion of vulvar/scrotal folds can be delayed, leading to confusion or misdiagnosis. 4 Sonographic markers for prenatal diagnosis include: 1 • Blunter and bulbous tip of the distal part of the penile shaft rather than the normal pointed morphology • Penile duct anomaly short or small • Shaft morphology of the distal part of the penis with severe ventral curvature which results from a fibrous band, the chordee, occurring in the projected course of the urethra • Observation of small lateral folds, epithelial remnants of the foreskin 3 and the presence of an abnormal urine stream 1,6 • The tulip sign 1…”

“…2 Recently, 3D US has been used for helping in improving the correct and most exact diagnosis. 1,3 Based on a recently observed case, we describe the new possibilities of 3D modes.…”