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Fetus has hypspadias with peno-scrotum transposition, nutrient deficient. Outcome of surgery? Problems due to head to body ratio?

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hi doctor,

my unborn baby, now 34 weeks, has issues with his/her reproductive system
currently, the baby is believed to be a male with few issues.

1. sever hypospadias with peno-scrotum transposition (this is why its hard to distinguish sex)
2. nutrient difficient- head is measured around 36 weeks while body is 32 weeks

my question is,
1. how good will the outcome of the surgery be for the hypospadias and transposition problem? will it affect its function? how about wanting to have a baby in the future?

2. head to body ratio seems scary. any problems we should look out for?

thanks, XXXXXXX
Posted Fri, 27 Apr 2012 in Child Health
Answered by Dr. Santosh Kondekar 11 hours later

Thank you for posting your query.

I understand your concern.

I can understand the anomalous situation of the unborn baby. Most hypospadias may have good prognosis if good penile length can be provided (this may not be possible on fetal scans).

Since you talk about transposition, i feel it may fall under ambiguous genitalia which runs a wide spectrum from very good prognosis to infertility in future.

A chromosomal study or amniotic fluid analysis may confirm the real sex of the fetus.. Often things may not be easy to appreciate in fetal scans and things may be changing till birth to some extent especially as testes come down and form scrotum.

Nutrient deficit as you had mentioned.. too has some acceptable variations, but with some calculations (ponderal index) ity may be easy to confirm any possibility of growth retardation in uterus.. has many reasons though.

Currently, best strategy is to plan a hospital delivery, discuss with doctor if there may be any possibility of delivery by Cesarean section. Immediately after birth insist for a Neonatologist and pediatric surgeon to see and then plan the surgery at later date.

When head/body ratio is abnormal watch out for low sugar and jaundice in first week after birth.

If you have any further queries, I would be happy to answer.

Wishing your baby a safe transition into the outer world.

Above answer was peer-reviewed by
Follow-up: Fetus has hypspadias with peno-scrotum transposition, nutrient deficient. Outcome of surgery? Problems due to head to body ratio? 6 hours later
hi Dr.,

it seems its more of a bifid scrotum than peon scrotom transposition. will it still fall under ambiguous genetalia? is bifid scrotum less problematic than peon-scrotom transposition?

thanks for your help

best regards, XXXXXXX
Answered by Dr. Santosh Kondekar 5 hours later
Hi again,

The answer to your both queries is Yes! It would still fall under ambiguous genitalia.

Bifid scrotum is less problematic when compared to Peno- scrotal transposition. Best decision regarding diagnosis is done only after birth.

Hope this helps.

Above answer was peer-reviewed by
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