Hypospadias Workup

  • Author: John M Gatti, MD; Chief Editor: Marc Cendron, MD   more...
 
Updated: Aug 11, 2011
 

Imaging Studies

Upper urinary tract anomalies are rarely associated with hypospadias and do not justify routine imaging in these patients unless other organ system anomalies are present. Other associated findings are more common (eg, enlarged prostatic utricle, low-grade vesicoureteral reflux) but are of little consequence clinically unless other symptoms merit evaluation.[12]

Proceed to Treatment & Management
 
 
Contributor Information and Disclosures
Author

John M Gatti, MD  Associate Professor and Director of Minimally Invasive Urology, Department of Pediatric Surgery and Urology, Children's Mercy Hospital; Assistant Professor, Department of Pediatric Surgery and Urology, University of Missouri School of Medicine at Kansas City, Missouri; Assistant Clinical Professor, Division of Pediatric Urology, University of Kansas School of Medicine at Kansas City, Kansas

John M Gatti, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Pediatrics, American Urological Association, Society for Fetal Urology, and Society for Pediatric Urology

Disclosure: Nothing to disclose.

Coauthor(s)

Andrew J Kirsch, MD, FAAP, FACS  Clinical Professor of Urology, Emory University School of Medicine, Children's Healthcare of Atlanta; President, Georgia Urology, PA

Andrew J Kirsch, MD, FAAP, FACS is a member of the following medical societies: American Academy of Pediatrics, American Urological Association, and Society for Fetal Urology

Disclosure: QMED Grant/research funds Investigation, Consulting; COOK Urological Royalty Consulting

Howard M Snyder III, MD  Professor, Department of Surgery, Division of Pediatric Urology, University of Pennsylvania School of Medicine

Howard M Snyder III, MD is a member of the following medical societies: American Academy of Pediatrics, American College of Surgeons, American Medical Association, American Urological Association, and National Kidney Foundation

Disclosure: Nothing to disclose.

Specialty Editor Board

Martin David Bomalaski, MD, FAAP  Pediatric Urologist, Alpine Urology

Martin David Bomalaski, MD, FAAP is a member of the following medical societies: Alpha Omega Alpha, American Academy of Pediatrics, and American Urological Association

Disclosure: Nothing to disclose.

Mary L Windle, PharmD  Adjunct Associate Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Nothing to disclose.

Harry P Koo, MD  Chairman of Urology Division and Director of Pediatric Urology, Professor of Surgery, Virginia Commonwealth University School of Medicine, Medical College of Virginia; Director of Urology, Children's Hospital of Richmond

Harry P Koo, MD is a member of the following medical societies: American Academy of Pediatrics, American College of Surgeons, and American Urological Association

Disclosure: Nothing to disclose.

Daniel Rauch, MD, FAAP  Director, Pediatric Hospitalist Program, Associate Professor, Department of Pediatrics, New York University School of Medicine

Daniel Rauch, MD, FAAP is a member of the following medical societies: Ambulatory Pediatric Association, American Academy of Pediatrics, and Society of Hospital Medicine

Disclosure: Baxter Honoraria Consulting

Chief Editor

Marc Cendron, MD  Associate Professor of Surgery, Harvard School of Medicine; Consulting Staff, Department of Urological Surgery, Children's Hospital Boston

Marc Cendron, MD is a member of the following medical societies: American Academy of Pediatrics, American Urological Association, European Society for Paediatric Urology, Johns Hopkins Medical and Surgical Association, New Hampshire Medical Society, Society for Fetal Urology, and Society for Pediatric Urology

Disclosure: Nothing to disclose.

References

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Proximal shaft hypospadias is shown. Note the deficient ventral foreskin, blind urethral pit at the glanular level, and lighter pigmented urethral plate extending to the true meatus at the proximal shaft level.
Proximal shaft hypospadias is shown. Note the typical dorsal hood of foreskin and ventral penile skin deficiency.
Penoscrotal hypospadias is shown. Note the associated ventral chordee and true urethral meatus located at the scrotal level.
Severe penile chordee is shown. Note the extreme ventral curvature of the penile shaft.
Penoscrotal transposition is shown. Note the rugated scrotal skin lateral to the penis, cephalad to its normal position.
A pedicled preputial island flap is shown. This hairless skin flap will be rotated on its vasculare pedicle to the ventrum of the penis for repair of the urethra.
Tubularized incised plate (TIP) technique. The urethral plate has been incised in the dorsal midline, expanding the width of the plate and allowing it to hinge forward for tubularization.
A urethrocutaneous fistula has appeared after hypospadias repair. Note one stream from true urethral meatus, and second stream through more proximal fistula.
 
 
 
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