Hypospadias, in which the urethra opens on the underside of the penis, is infrequently seen (Fig. 40-9). However, it is important that hypospadias is recognized early, preferably at the initial newborn examination. It can occur with or
Abnormality |
Physical Finding |
Epididymitis, orchitis |
Tender mass |
Hydrocele |
Transilluminates |
Inguinal hernia |
Does not transilluminate |
Testicular torsion |
Pain and loss of cremasteric reflex |
Torsion of the appendix testis |
Blue dot sign |
Trauma |
Tender scrotum, edema, trauma history |
Tumor |
Solid mass |
Spermatocele |
Nontender cystic mass |
Varicocele |
Bag of worms appearance |
without chordee (curvature). Circumcision should be withheld and a urology consultation obtained. Hypospadias must be differentiated from ambiguous genitalia, which implies an intersex disorder. Epispadias, in which the meatus is located on the dorsal surface of the penis, is uncommon and is usually associated with extrophy of the bladder.
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