Hypospadias Differential Diagnoses

Updated: Jun 16, 2019
  • Author: John M Gatti, MD; Chief Editor: Marc Cendron, MD  more...
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DDx

Diagnostic Considerations

In 1981, a review by Khuri of more than 1000 patients with hypospadias reported that the incidence of undescended testes and inguinal hernias was 9% for each. [17] With more severe forms of hypospadias, the incidence of undescended testes exceeded 30%, and the incidence of inguinal hernias approached 20%. It is important to evaluate the position of the testes and assess for the presence of inguinal hernia as part of the physical examination for hypospadias.

The combination of hypospadias and undescended testis can be an indicator of an underlying difference/disorder of sex development (DSD). [18] In a 1999 study by Kaefer et al, DSD states were identified in approximately 30% of patients with unilateral or bilateral undescended testes and hypospadias, and more proximal meatal location carried a higher association of DSD states than more distal meatal location. [19] If any gonad was nonpalpable, the incidence rose to 50%; however, if both gonads were palpable, the incidence was only 15%.

A prostatic utricle is occasionally noted when catheterization of the urethra is attempted in patients with hypospadias.

Differential Diagnoses