Skip to main content

Radiological Evaluation of Hypospadias Patients

  • Chapter
  • First Online:
Hypospadiology

Abstract

While hypospadias primarily remains a clinical diagnosis, radiological imaging, nonetheless, has a critical role to play. Antenatal Ultrasound provides information about the anatomy of the external genitalia and even diagnose some cases of severe hypospadias. Ultrasound is an emerging modality for the investigation of hypospadias. It offers excellent visualization of the penile tissues. The addition of sonoelastography provides information regarding tissue elasticity, giving the urologist additional details of various variables like chordee tissue, spongiosum quality, and urethral plate width which help in decision-making. MRI can provide additional information in both antenatal and postnatal patients. Radiological investigations such as genitography and MRI have a crucial role in diagnosing and evaluating DSD and its associated anomalies.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 169.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 219.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 219.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Abbreviations

CECT:

Contrast Enhanced Computerized Tomogram

CT:

Computerized Tomogram

DSD:

Disorders of Sexual Differentiation

MRI:

Magnetic Resonance Imaging

RGU:

Retrograde Urethrogram

USG:

Ultrasonography

VCUG:

Voiding Cysto-Urethrogram

References

  1. Bhat A, Kumar V, Bhat M, Kumar R, Patni M, Mittal R. The incidence of apparent congenital urogenital anomalies in North Indian newborns: a study of 20,432 pregnancies. Afr J Urol. 2016;22(3):183–8.

    Article  Google Scholar 

  2. Hackett LK, Tarsa M, Wolfson TJ, Kaplan G, Vaux KK, Pretorius DH. Use of multiplanar 3-dimensional ultrasonography for prenatal sex identification. J Ultrasound Med. 2010;29(2):195–202.

    Article  Google Scholar 

  3. Meizner I, Mashiach R, Shalev J, Efrat Z, Feldberg D. The 'tulip sign': a sonographic clue for the in-utero diagnosis of severe hypospadias. Ultrasound Obstet Gynecol. 2002;19(3):250–3.

    Article  CAS  Google Scholar 

  4. Hörmann M, Brugger PC, Balassy C, Witzani L, Prayer D. Fetal MRI of the urinary system. Eur J Radiol. 2006;57(2):303–11.

    Article  Google Scholar 

  5. Lissauer D, Morris RK, Kilby MD. Fetal lower urinary tract obstruction. Semin Fetal Neonatal Med. 2007;6. Elsevier:464–70.

    Article  Google Scholar 

  6. Alamo L, Laswad T, Schnyder P, Meuli R, Vial Y, Osterheld M-C, Gudinchet F. Fetal M.R.I. as a complement to the U.S. in the diagnosis and characterization of anomalies of the genito-urinary tract. Eur J Radiol. 2010;76(2):258–64.

    Article  Google Scholar 

  7. Nakamura Y, Jennings RW, Connolly S, Diamond DA. Fetal diagnosis of penoscrotal transposition associated with perineal lipoma in one twin. Diag Ther. 2010;27(3):164–7.

    Article  Google Scholar 

  8. Nemec SF, Kasprian G, Brugger PC, Bettelheim D, Nemec U, Krestan CR, Rotmensch S, Rimoin DL, Graham JM, Prayer D. Abnormalities of the penis in utero–hypospadias on fetal MRI. J Perinat Med. 2011;39(4):451–6.

    Article  Google Scholar 

  9. Fernandes MAV, Souza LRMFD, Cartafina LP. Ultrasound evaluation of the penis. Radiol Bras. 2018;51(4):257–61.

    Article  Google Scholar 

  10. Wilkins C, Sriprasad S, Sidhu P. Colour doppler ultrasound of the penis. Clin Radiol. 2003;58(7):514–23.

    Article  CAS  Google Scholar 

  11. Medicine AIoUi, Association A.U. A.I.U.M. practice guideline for performing an ultrasound examination in urology practice. J Ultrasound Med. 2012;31(1):133–44.

    Article  Google Scholar 

  12. Avery LL, Scheinfeld MH. Imaging of penile and scrotal emergencies. Radiographics. 2013;33(3):721–40.

    Article  Google Scholar 

  13. Bhatt S, Kocakoc E, Rubens DJ, Seftel AD, Dogra VS. Sonographic evaluation of penile trauma. J Ultrasound Med. 2005;24(7):993–1000. quiz 1001

    Article  Google Scholar 

  14. Bhat A, Sabharwal K, Bhat M, Saran R, Singla M, Kumar V. Outcome of tubularized incised plate urethroplasty with spongioplasty alone as additional tissue cover: a prospective study. Indian J Urol. 2014;30(4):392.

    Article  Google Scholar 

  15. Schultz JR, Klykylo WM, Wacksman J. Timing of elective hypospadias repair in children. Paediatrics. 1983;71(3):342–51.

    Article  CAS  Google Scholar 

  16. Camoglio FS, Bruno C, Zambaldo S, Zampieri N. Hypospadias anatomy: elastosonographic evaluation of the normal and hypospadic penis. J Pediatr Urol. 2016;12(4):199:1−5.

    Google Scholar 

  17. Milla SS, Chow JS, Lebowitz RL. Imaging of hypospadias: pre-and postoperative appearances. Pediatr Radiol. 2008;38(2):202–8.

    Article  Google Scholar 

  18. Cimador M, Vallasciani S, Manzoni G, Rigamonti W, De Grazia E, Castagnetti M. Failed hypospadias in paediatric patients. Nat Rev Urol. 2013;10(11):657.

    Article  Google Scholar 

  19. Satragno L, Martinoli C, Cittadini G. Magnetic resonance imaging of the penis: Normal anatomy. Magn Reson Imaging. 1989;7(1):95–100. https://doi.org/10.1016/0730-725X(89)90329-9.

    Article  CAS  PubMed  Google Scholar 

  20. Vossough A, Pretorius E, Siegelman E, Ramchandani P, Banner M. Magnetic resonance imaging of the penis. Abdom Radiol. 2002;27(6):640.

    CAS  Google Scholar 

  21. Kirkham AP, Illing RO, Minhas S, Minhas S, Allen C. M.R. imaging of nonmalignant penile lesions. Radiographics. 2008;28(3):837–53.

    Article  Google Scholar 

  22. Kureel SN, Gupta A, Sunil K, Dheer Y, Kumar M, Tomar VK. Surgical anatomy of the penis in hypospadias magnetic resonance imaging study of the tissue planes, vessels, and collaterals. Urology. 2015;85(5):1173–8.

    Article  Google Scholar 

  23. Wu W-H, Chuang J-H, Ting Y-C, Lee S-Y, Hsieh C-S. Developmental anomalies and disabilities associated with hypospadias. J Urol. 2002;168(1):229–32.

    Article  Google Scholar 

  24. Kulkarni B, Oak S, Patel M, Merchant S, Borwankar S. Developmental anomalies associated with hypospadias. J Postgrad Med. 1991;37(3):140.

    CAS  PubMed  Google Scholar 

  25. Moshiri M, Chapman T, Fechner PY, Dubinsky TJ, Shnorhavorian M, Osman S, Bhargava P, Katz DS. Evaluation and management of disorders of sex development: a multidisciplinary approach to a complex diagnosis. Radiographics. 2012;32(6):1599–618.

    Article  Google Scholar 

  26. Cohen H, Shapiro M, Mandel F, Shapiro M. Normal ovaries in neonates and infants: a sonographic study of 77 patients 1 day to 24 months old. Am J Roentgenol. 1993;160(3):583–6.

    Article  CAS  Google Scholar 

  27. Wright N, Smith C, Rickwood A, Carty H. Imaging children with ambiguous genitalia and intersex states. Clin Radiol. 1995;50(12):823–9.

    Article  CAS  Google Scholar 

  28. Sivit C, Hung W, Taylor G, Catena L, Brown-Jones C, Kushner D. Sonography in neonatal congenital adrenal hyperplasia. Am J Roentgenol. 1991;156(1):141–3.

    Article  CAS  Google Scholar 

  29. Bryan P, Caldamone A, Morrison S, Yulish B, Owens R. Ultrasound findings in the adreno-genital syndrome (congenital adrenal hyperplasia). J Ultrasound Med. 1988;7(12):675–9.

    Article  CAS  Google Scholar 

  30. Davis DM. Surgical treatment of hypospadias, especially scrotal and perineal. J Urol. 1951;65(4):595–602.

    Article  CAS  Google Scholar 

  31. Garel L. Abnormal sex differentiation: who, how and when to image. Pediatr Radiol. 2008;38:508.

    Article  Google Scholar 

  32. Sohaib S, Cook G, Koh D-M. Imaging studies for germ cell tumours. Hematol Oncol Clin. 2011;25(3):487–502.

    Article  CAS  Google Scholar 

  33. Secaf E, Hricak H, Gooding C, Ho V, Gorczyca D, Ringertz H, Conte F, Kogan B, Grumbach M. Role of M.R.I. in the valuation of ambiguous genitalia. Pediatr Radiol. 1994;24(4):231–5.

    Article  CAS  Google Scholar 

  34. Kanemoto K, Hayashi Y, Kojima Y, Maruyama T, Ito M, Kohri K. Accuracy of ultrasonography and magnetic resonance imaging in diagnosing non-palpable testis. Int J Urol. 2005;12(7):668–72.

    Article  Google Scholar 

  35. Kantarci M, Doganay S, Yalcin A, Aksoy Y, Yilmaz-Cankaya B, Salman B. Diagnostic performance of diffusion-weighted M.R.I. in the detection of nonpalpable undescended testes: comparison with conventional M.R.I. and surgical findings. Am J Roentgenol. 2010;195(4):W268–73.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2022 The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Prakash, A., Bhat, M., Bhat, A. (2022). Radiological Evaluation of Hypospadias Patients. In: Bhat, A. (eds) Hypospadiology . Springer, Singapore. https://doi.org/10.1007/978-981-16-8395-4_29

Download citation

  • DOI: https://doi.org/10.1007/978-981-16-8395-4_29

  • Published:

  • Publisher Name: Springer, Singapore

  • Print ISBN: 978-981-16-8394-7

  • Online ISBN: 978-981-16-8395-4

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics