Hypospadias Differential Diagnoses

Updated: May 15, 2017
  • Author: John M Gatti, MD; Chief Editor: Marc Cendron, MD  more...
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DDx

Diagnostic Considerations

Undescended testes and inguinal hernias are the anomalies most commonly associated with hypospadias; look for undescended testes and inguinal hernias during the review of symptoms and physical examination. 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. [16] With more severe forms of hypospadias, the incidence of undescended testes exceeded 30%, and the incidence of inguinal hernias approached 20%.

The combination of hypospadias and undescended testis can be an indicator of an underlying disorder of sex development (DSD). [17] 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. [18] 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