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Oral Presentation - 31
In which cases of proximal hypospadias detailed investigations are necessary
Gökmen Aydınbaş 1, Ayşe Karaman 2, Semra Çetinkaya 2, İbrahim Karaman 2
1 Dr. Sami Ulus Maternity and Children's Training and Research Hospital, Department of Pediatric Surgery
2 Dr. Sami Ulus Maternity and Children Training and Research Hospital, Department of Pediatric Surgery, Ankara
Objective: The aim of this study was to evaluate the differences in physical examination and
radiologic findings of patients with proximal hypospadias in terms of Disorders of Sex
Development (DSD) groups.
Materials and Methods: The ages, physical examination and radiological findings and
diagnoses of the cases aged 0-18 years who were admitted to our hospital due to proximal
hypospadias between 2005-2022 and whose male gender was determined as a result of their
evaluation for DSD were evaluated.
Results: There were 43 patients with a median age of 4 months (1 day-14 years). Nineteen of
the patients had penoscrotal (44.2%), 13 had scrotal (30.2%), and 11 had perineal (25.6%)
hypospadias. All patients had severe ventral curvature, and penile length was below 2.5
standard deviations for age in 33 patients (76.7%). Bifid scrotum was detected in 28 cases
(65.1%) and penoscrotal transposition was detected in 13 cases (30.2%). Twenty of the
patients (46.5%) had bilateral and 12 had unilateral (27.9%) undescended testes. There were
46,XY DSD in 33 patients (76.7%), Sex chromosome DSD in 5 patients (11.6%), 46,XX
Ovotesticular DSD in 2 patients (4.7%) and karyotype anomalies other than DSD groups
were detected in 3 patients (7%). Undescended testis and/or micropenis were present in 37
patients (92.5%) in DSD groups (p=0.709). Uterine remnant was detected in 7 cases in the
DSD groups (16.3%), 5 of these cases had perineal and 2 had scrotal hypospadias (p=0.008).
Penoscrotal hypospadias was found only in the 46,XY DSD group (p=0.022).
Conclusion: Patients with proximal hypospadias accompanied by undescended testis and/or
micropenis should be evaluated in detail before any surgical intervention. We believe that
especially in cases with scrotal and perineal hypospadias should be investigated for possible
uterine remnants.