Journal of pediatric urology · 2026
Evaluation of penoscrotal transposition associated with complex hypospadias and concealed penis: Photographically controlled analysis of surgically treated patients and proposal of a novel classification (The Corrêa-Macedo classification).
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Corrêa Renata Alves, Balladares Rafael Jordan, Barroso Sacoman Débora Laena, Leal da Cruz Marcela, Macedo Antonio
Аннотация
PURPOSE: This study aimed to propose and validate a novel classification for penoscrotal transposition and estimate the frequency of its different degrees in patients with complex hypospadias, buried penis, and in controls.
METHODS: This was a retrospective, descriptive, longitudinal study of consecutive cases, based on standardized photographic evaluation of patients operated between 2010 and 2021. The study included 23 patients with complex hypospadias and 50 patients with buried penis. Additionally, a prospective control group of 90 children without genital anomalies was analyzed. The proposed classification was compared to existing systems using appropriate statistical tests, validated by expert reviewers, and subsequently applied to the clinical subgroups and the control group.
RESULTS: We demonstrated an accuracy of 87.1 %, significantly higher than that of previously established methods (p < 0.0001). Moderate penoscrotal transposition predominated among patients with buried penis (68 %), while severe transposition was more frequent in cases of complex hypospadias (60.9 %). In the control group, mild (41.1 %) and moderate (33.3 %) forms of transposition were observed, even in the absence of diagnosed genital anomalies.
CONCLUSIONS: The predominance of moderate and severe forms among surgical patients reinforces the etiopathogenic association between penoscrotal transposition, complex hypospadias, and buried penis. The presence of varying degrees of transposition in children without genital anomalies highlights the need for systematic evaluation of scrotal positioning in children and question what is "the normal scrotal insertion" in the general population.
METHODS: This was a retrospective, descriptive, longitudinal study of consecutive cases, based on standardized photographic evaluation of patients operated between 2010 and 2021. The study included 23 patients with complex hypospadias and 50 patients with buried penis. Additionally, a prospective control group of 90 children without genital anomalies was analyzed. The proposed classification was compared to existing systems using appropriate statistical tests, validated by expert reviewers, and subsequently applied to the clinical subgroups and the control group.
RESULTS: We demonstrated an accuracy of 87.1 %, significantly higher than that of previously established methods (p < 0.0001). Moderate penoscrotal transposition predominated among patients with buried penis (68 %), while severe transposition was more frequent in cases of complex hypospadias (60.9 %). In the control group, mild (41.1 %) and moderate (33.3 %) forms of transposition were observed, even in the absence of diagnosed genital anomalies.
CONCLUSIONS: The predominance of moderate and severe forms among surgical patients reinforces the etiopathogenic association between penoscrotal transposition, complex hypospadias, and buried penis. The presence of varying degrees of transposition in children without genital anomalies highlights the need for systematic evaluation of scrotal positioning in children and question what is "the normal scrotal insertion" in the general population.