title: Hypospadias anatomy: Elastosonographic evaluation of the normal and hypospadic penis.
abstract: BACKGROUND
  Hypospadias is one of the most common congenital anomalies in childhood. The aim of this study is to apply elastosonography on normal and hypospadic penis to verify the structural differences in tissues composition and stiffness.
  
  
  METHODS
  We analyzed medical chart of patients treated at our Institution for hypospadias during the period December 2005 and December 2014 (group 1). Other two groups were enrolled for this study: group 2- patients with hypospadias waiting for surgery and group 3-patients without hypospadias. Inclusion and exclusion criteria were created; all patients underwent penile ultrasound and elastosonography. Elastographic index of elasticity was defined as soft, medium-hard or hard. We assigned the value 1 to soft tissue, 2 and 3 to medium-hard and hard respectively.
  
  
  RESULTS
  During the study period 294 patients were treated for hypospadias. After reviewing medical chart 115 patients were considered for analysis (group 1). 22 patients were enrolled in group 2 and 38 patients were enrolled in group 3. Group 1: 7 proximal hypospadias, 29 penile hypospadias, 79 distal hypospadias. Patients with hypospadias had malformation also at corpus spongiosum and cavernosum respect to controls. Elastography showed a corpus spongiosum stiffness defined as medium-hard or hard in all cases of the pathologic group and soft in all the subjects of the control group (p < 0.05).
  
  
  CONCLUSIONS
  Elastosonography showed how the hypospadia anatomy is deeply altered, even in an anatomical area far from meatal abnormality: corpus spongiosum in hypospadic penis seems to be globally stiffer and less elastic and cavernous corpora are less developed.
authors.affiliation: Department of Surgery, Pediatric Surgical Unit, Policlinico G.B. Rossi, University of Verona, Verona, Italy.
authors.forename: Francesco Saverio
authors.initials: FS
authors.lastname: Camoglio
authors.affiliation: Department of Radiology, Policlinico G.B. Rossi, University of Verona, Verona, Italy.
authors.forename: Costanza
authors.initials: C
authors.lastname: Bruno
authors.affiliation: Department of Surgery, Pediatric Surgical Unit, Policlinico G.B. Rossi, University of Verona, Verona, Italy.
authors.forename: Silvia
authors.initials: S
authors.lastname: Zambaldo
authors.affiliation: Department of Surgery, Pediatric Surgical Unit, Policlinico G.B. Rossi, University of Verona, Verona, Italy. Electronic address: dr.zampieri@libero.it.
authors.forename: Nicola
authors.initials: N
authors.lastname: Zampieri
mesh_terms: D002675:Child, Preschool; D054459:Elasticity Imaging Techniques; D006801:Humans; D007021:Hypospadias / Q000000981:diagnostic imaging* / Q000473:pathology*; D007223:Infant; D008297:Male; D010413:Penis / Q000033:anatomy & histology* / Q000000981:diagnostic imaging* / Q000473:pathology
keywords: Chordee; Elastosonography; Functional results; Hypospadias