Analysis of associated scrotal anomalies in boys with hypospadias

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Background Hypospadias is a common congenital anomaly of the penis characterized by ventral opening of urethra. This abnormality is often accompanied by scrotal abnormalities, where both penile and scrotal development occur at the same time during the fetal period. This study aims to analyze associated scrotal anomalies in children with hypospadias. Methods This is a retrospective cross-sectional study of boys diagnosed with hypospadias during a 6 years period. The age of patients, severity of hypospadias, and associated scrotal anomalies such as penoscrotal transposition (PST), bifid scrotum (BS), and scrotal hypoplasia were assessed. Scrotoplasty procedure was also recorded. The association between the severity of hypospadias, incidence of scrotal anomalies, severity of both PST and BF were analyzed using Chi-square test and alternatively Fisher exact test, p<0,05 considered significant. Results During the study period, there were 240 hypospadias patients, with a median age of 5,6 years. Most patients had severe hypospadias. Associated scrotal anomalies were found in 63,3% of patients. Incidence of scrotal anomaly was higher in patients with severe hypospadias (75%) compared to mild cases (75% vs 36.1%; p<0.001; PR= 2.08 (95% CI: 1.51 – 2.86)). Patients with severe hypospadias had a more severe PST, especially in bilateral minor and major forms compared to patients with mild cases (p<0.001); and was significantly associated with severe and partial type of SB (p<0.001). Patients with a more severe PST tend to have a more severe SB, on contrary, patients with minor PST tend to have a milder or even no BS (p<0.001). Scrotoplasty was performed in 35,4% of cases. Conclusion Most hypospadias patients had associated scrotal anomaly, in which severe hypospadias was associated with the more severe type of PST and BS.