Ultrasound diagnosis of hypospadias in foetus shows high accuracy
Foetal ultrasound diagnosis of hypospadias appears to demonstrate a high positive predictive value for a penile anomaly and a moderately high positive predictive value for the specific diagnosis of hypospadias as compared with a postnatal diagnosis based on physical exam, according to a single-centre retrospective study.
Researchers examined pregnant women who were referred to a foetal care centre and found to carry a foetus with an ultrasound diagnosis of possible hypospadias or who had a new diagnosis of hypospadias after imaging. A total of 32 cases of possible hypospadias were identified.
Results showed that the foetal care ultrasound suggested hypospadias in 78 percent of the 32 suspected cases. Of the 25 cases, 18 were confirmed to have hypospadias on postnatal physical exam, yielding a positive predictive value of 72 percent; and 21 were found to have either hypospadias or another penile anomaly on postnatal physical exam, yielding a positive predictive value for any genital anomaly of 84 percent.
Infants with confirmed hypospadias frequently had several associated genitourinary anomalies on postnatal clinical exam.
An abnormality of anterior urethral and penile development, hypospadias occurs when the urethral folds fail to fuse. The urethral opening is located at a ventral location of the penis, proximal to the tip of the glans penis, which is splayed open. Hypospadias accounts for 68.3 percent of all cases of congenital penile anomalies. Orthoplasty is the best method of treatment, with both ultrasound and foetal MRI being used in diagnosing the foetus. [J Urol 2005;174:1573–1576; Pediatr Surg Int 2015 31:519–527; J Perinat Med 2011;39:451–456; Fetal Diagn Ther 2010;27:164–167]