Management of Hypospadias

Diagnostic Evaluation

• If proximal hypospadias is present, especially with undescended testes, endocrinological evaluation is recommended to exclude disorders of sexual development, as suggested by guidelines from the American Urological Association 1

Imaging Considerations

• Renal and bladder ultrasound should be performed to screen for urinary tract anomalies, particularly if the child has posterior (proximal) hypospadias, and in cases with moderate to severe hydronephrosis on ultrasound, a voiding cystourethrogram (VCUG) may be indicated to evaluate for vesicoureteral reflux and other urinary tract abnormalities, as recommended by the American College of Radiology 2
• VCUG is particularly important in males with suspected posterior urethral valves, which can present with similar symptoms, according to the American College of Radiology 2