Hypospadias with cryptorchidism presented as ambiguous genitalia and its management with surgery

M. Nooruzzaman; A. K. M. Zahid Hossain; M. Kamrul Hassan Shabuj; Susankar Kumar Mondal; Noor Mahammad; K. M. Saiful Islam; Umme Habiba Dilshad Munmun; Tarafder Mohammad Atiquzzaman

doi:10.18203/2349-3291.ijcp20232234

Authors

M. Nooruzzaman Department of Pediatric Surgery, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
A. K. M. Zahid Hossain Department of Pediatric Surgery, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
M. Kamrul Hassan Shabuj Department of Neonatology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
Susankar Kumar Mondal Department of Pediatric Surgery, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
Noor Mahammad Department of Pediatric Surgery, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
K. M. Saiful Islam Department of Pediatric Surgery, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
Umme Habiba Dilshad Munmun Department of Pediatric Surgery, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
Tarafder Mohammad Atiquzzaman Department of Pediatric Surgery, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh

DOI:

https://doi.org/10.18203/2349-3291.ijcp20232234

Keywords:

Hypospadias, Cryptorchidism, Pediatric surgery

Abstract

Background: The incidence of hypospadias with cryptorchidism is about 6-31.6%. Current management recommendations are that undescended testis beyond three months needs surgery between 6-12 months of age. Proximal hypospadias and cryptorchidism overlap with disorders of sex development and endocrine problem. The aim of this study was to assess the outcome of surgical management of hypospadias with cryptorchidism, at selected centers in Dhaka, Bangladesh.

Methods: This prospective study was conducted in the Department of Pediatric Surgery of Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh during the period from January, 2018 to January, 2022. In this study, we included 70 diagnosed cases of hypospadias with cryptorchidism presented as ambiguous genitalia who underwent surgery.

Results: Mean age at surgery was 4.6±1.4 years and majority (91.4%) were male. Associated renal anomalies were absent in 81.4% cases, symptomatic renal anomalies were present in 11% cases, severe chordee was 62.9%. Abnormal hemiscrotum was 98.6% and normal hemiscrotum was 1.4%. Hernia with cryptorchidism was present in 30 % cases. Testosterone was normal in 94.3% patients, estrogen and progesterone was elevated in 5.7% patients. After operation, male was 94.3% and female was 2.9%, chordee condition was corrected in 81.4% and urine passed through tip of penis in 84.3% patients.

Conclusions: We found that surgery is simple, safe, and effective in the treatment of patients with hypospadias and cryptorchidism with satisfactory functional results, normal physical health status, improved quality of life, satisfying psychological support and probably less pain.

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