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Surgical treatment of disorders of sexual development
Published in Mark Davenport, James D. Geiger, Nigel J. Hall, Steven S. Rothenberg, Operative Pediatric Surgery, 2020
Rafael V. Pieretti, Patricia K. Donahoe
Partial or complete penoscrotal transposition is often found in cases with penoscrotal and perineal hypospadiac (Figure 80.18). The least severe forms are known as bifid scrotum, prepenile scrotum (Figure 80.19a), and shawl scrotum. The scrotoplasty should be delayed until after the hypospadias repair is completed, to assure vascularization because the distal flaps needed for the hypospadias repair must be divided and displaced during correction of the prepenile scrotum. Six months or more should elapse between the urethroplasty and repositioning of the scrotum. This anomaly is repaired by displacing scrotal skin posteriorly and the penis anteriorly. The base of the penis is advanced forward onto the anterior abdominal wall by creating a square, distally based flap, which circumscribes the base of the penis. The flap is dropped distally to restore normal scrotal length. The abdominal wall is then undermined and swung around the base of the penis to join ventrally in the midline. It is important to mobilize the anterior abdominal wall flaps sufficiently so that midline separation does not occur. See Figure 80.19b–f.
Hypospadias
Published in Brice Antao, S Irish Michael, Anthony Lander, S Rothenberg MD Steven, Succeeding in Paediatric Surgery Examinations, 2017
Eighty per cent of hypospadias are minor, involving glanular and penile hypospadias form, whereas only 20% are classified as scrotal or perineum. The latter forms frequently occur in association with other genital anomalies such as micropenis, bifid scrotum, penoscrotal transposition, cryptorchidism, partial or complete androgen insensitivity syndrome and may also occur in association with malformations of other organs.
Male genital anomalies
Published in Prem Puri, Newborn Surgery, 2017
Rare anomalies of the penis may present at birth, including urethral duplication (Figure 110.3) and megalourethra, which may be associated with prune belly syndrome.20 Partial duplication of the caudal embryo may lead to duplication of the penis, while penile “agenesis” is usually a form of posterior ectopia, with the erectile tissue and urethra buried in the perineal body and the meatus on the anterior lip of the anal canal.29–31 The latter anatomy is similar to the normal situation in marsupials, where the scrotum is inguinal in position and the phallus is in the perineum. Minor variants of penoscrotal transposition are common in DSD patients.32
Accessory Scrotum
Published in Fetal and Pediatric Pathology, 2020
Fatma Fitouri, Nesrine Chebil, Sabrine Ben Ammar, Sondes Sahli, Mourad Hamzaoui
Congenital scrotal anomalies are conventionally classified into four types: bifid scrotum, penoscrotal transposition, ectopic scrotum and accessory scrotum [1]. There are approximately over 30 cases of accessory scrotum reported in the literature [1].