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

Table 40-4 Selected Differential Diagnosis of Scrotal Masses with Physical Findings


Physical Finding

Epididymitis, orchitis

Tender mass



Inguinal hernia

Does not transilluminate

Testicular torsion

Pain and loss of cremasteric reflex

Torsion of the appendix testis

Blue dot sign


Tender scrotum, edema, trauma history


Solid mass


Nontender cystic mass


Bag of worms appearance

Figure 40-9 Hypospadias. (From Borer JG, RetikAB. Hypospadias. In Wein AJ[ed]. Campbell-Walsh Urology, 9th ed, vol IV, Philadelphia, Elsevier, 2007.)

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.

Was this article helpful?

0 0
Natural Treatments For Psoriasis

Natural Treatments For Psoriasis

Do You Suffer From the Itching and Scaling of Psoriasis? Or the Chronic Agony of Psoriatic Arthritis? If so you are not ALONE! A whopping three percent of the world’s populations suffer from either condition! An incredible 56 million working hours are lost every year by psoriasis sufferers according to the National Psoriasis Foundation.

Get My Free Ebook

Post a comment