Caudal migration of the verumontanum

[Caudal migration of the verumontanum and enlargement of the utricle in hypospadias]

Hypospadias is one of the morphological and functional alterations of the internal urogenital organs under the influence of androgen deficiency. In the time period 1974-1998 a total of 823 cases of hypospadias were surgically treated and the findings of the preoperative X-ray diagnostics with micturating cystourethrogram (MCU) and urethrocystogram (UCG) as well as urethrocystoscopy were analyzed. A caudal migration of the verumontanum could be detected in 55% of cases with hypospadias (453/823) and in 79% (322/403) of middle grade (penoscrotal) and high grade (scrotoperineal) cases of hypospadias. Enlargement of the utricle was present in 31.5% (259/823) cases of hypospadias and in 46.2% (186/423) of middle grade (penoscrotal) and high grade (scrotoperineal) cases of hypospadias.

Ejaculatory ducts opening into accessory urethral channel with hypospadias and absent verumontanum: a rare association

Ejaculatory ducts draining into accessory urethral channel opening into perineum is rare. This is a case report of a 27-year-old male who had hypospadias surgery at 3 years of age, presenting with discharge of semen through the perineal opening from adolescence. Cystoscopy and dye study showed that it was a short channel communicating with both ejaculatory ducts. Cystoscopy of the native urethra revealed that the vermontanum had not developed. The mucous lined accessory urethra was anastomosed to the bulbar urethra. Urethrogram done after one year showed that the accessory urethra was draining well into the bulbar urethra. Such type of accessory urethral channel communicating with ejaculatory ducts and associated with hypospadias and absent vermontanum has not been reported so far.

Imaging of hypospadias: pre- and postoperative appearances

Hypospadias is a common condition that is typically diagnosed and repaired in early life. Boys with hypospadias can present with complications from their surgery months to years later. Imaging in patients with hypospadias is usually accomplished by retrograde urethrography (RUG) and less commonly by voiding cystourethrography (VCUG). This pictorial essay demonstrates the fluoroscopic appearances of hypospadias preoperatively as well as the normal postoperative appearance and a variety of complications that can occur.

Adenomatous Polyp of the Verumontanum Accompanied by Parabulbous Epidermoid Cyst and Cryptorchidism in an Adult Male

The coexistence of polyp of the verumontanum, epidermoid paraurethral cyst and cryptorchidism presents a mosaic of congenital anomalies of the urogenital tract. We present a 30-year-old patient with a medical history of unilateral cryptorchidism, urinary tract infections, obstructive voiding symptoms and perineal discomfort. Clinical and laboratory evaluation revealed a pending filling defect in the prostatic urethra and a palpable elastic mass located on the right side of the bulbar urethra. Transurethral resection of the urethral polyp with a simultaneous excision of the cystic formation via a perineal approach followed by a left-sided funiculolysis and orchiopexy were performed. Discussion focuses on the etiology and differential diagnosis of this unusual complex entity.

Lower genitourinary tract anomalies in a male with Down syndrome

A patient with Down syndrome is presented who had hypospadias, a large low implanted prostatic utricle, and refluxing ejaculatory ducts entering the utricle.