Hypospadias in Neonates: Associated Renal and Extra-Renal Anomalies Identified Through Routine Ultrasound Screening in a Tertiary NICU

Authors

  • Sulaiman A. Almunaifi
  • Aymen H. El Emmawie
  • Mohd U Tak
  • Mohammed A. Bayoumi
  • Mohamed H A Hassan

Keywords:

Neonates, hypospadias, associated urogenital anomalies, extra renal anomalies, abdominal ultrasound.

Abstract

Background: Hypospadias is one of the most prevalent genital birth abnormalities in males,it is second to undescended testis. There is some evidence that hypospadias coexists with other urinary system abnormalities.

Aim: This case series aimed to describe renal and extra-renal anomalies detected by routine ultrasound screening among neonates with hypospadias.

Methods: Retrospective case series including five neonates diagnosed with hypospadias in our unit over a two-year period, abdominal and pelvi-renal ultrasound was requested to exclude associated renal anomalies in addition to cranial ultrasound and Echocardiogram to exclude extra renal association.

Results: Three out of our five neonates showed renal anomalies. One patient had left renal agenesis and the other 2 patients had different grades of hydronephrosis.These findings were consistent with previous reports describing an association between hypospadias and renal/urogenital anomalies.

Conclusion: Hypospadias may be an early clinical marker of underlying renal or extra-renal anomalies. Additionally, hypospadias should not be undervalued as a urethral opening malformation because it could be the first sign of more serious urogenital or extra-renal abnormalities....

Downloads

Download data is not yet available.

References

Tain YL, Luh H, Lin CY, Hsu CN: Incidence and risks of congenital anomalies of kidney and urinary tract in newborns: A Population-Based Case-Control Study in Taiwan [published correction appears in Medicine (Baltimore) 95: e8733, 2016]. Medicine (Baltimore) 95: e2659, 2016 [DOI] [PMC free article] [PubMed] [Google Scholar]

2. Vasikar M , Indra R G .A Primer on Congenital Anomalies of the Kidneys and Urinary Tracts (CAKUT) Clin J Am Soc Nephrol 2020 Mar 18;15(5):723–731. doi: 10.2215/CJN.12581019

3. Keays MA, Dave S. Current hypospadias management: Diagnosis, surgical management, and long-term patient-centred outcomes. Can Urol Assoc J. 2017; 11(1-2Suppl1):S48-S53.

4. Bouty A, Ayers KL, Pask A, et al. The genetic and environmental factors underlying hypospadias. Sex Dev. 2015; 9:239–259.

5. Duckett JW. Hypospadias. Pediatr Rev. 1989; 11:37–42.

6. Friedman T, Shalom A, Hoshen G, et al. Detection and incidence of anomalies associated with hypospadias. Pediatr Nephrol. 2008; 23:1809–1816.

7. Opitz JM. The developmental field concept in clinical genetics. The Journal of Pediatrics 1982;101(5):805–09 doi: 10.1016/S0022-3476(82)80337-5. [PubMed: 7131167]

8. Feldkamp ML, Carey JC, Byrne JLB, Krikov S, Botto LD. Etiology and clinical presentation of birth defects: population based study. BMJ 2017;357:j2249 doi: 10.1136/bmj.j2249. [PubMed: 28559234]

9. Parikh CR, McCall D, Engelman C, Schrier RW. Congenital renal agenesis: Case-control analysis of birth characteristics. American Journal of Kidney Diseases 2002;39(4):689–94 doi: 10.1053/ajkd.2002.31982. [PubMed: 11920333]

10. van der Zanden LF, van Rooij IA, Feitz WF, et al. Aetiology of hypospadias: a systematic review of genes and environment. Hum Reprod Update. 2012; 18:260–283

11. Jasim A, Hemin SA. Urinary tract anomalies in patients with hypospadias. European journal of modern medicine and practice. Vol.4 No .9 Sept 2024

12. Ogundoyin OO, Olulana DI, Lawal TA. Experience with the management of anorectal malformations in Ibadan, Nigeria. Pan Afr Med J. 2021; 38.

13. Kahuruta JJ, Yongolo S, Kimu N, et al. Factors associated with clinically apparent congenital urethra anomalies among pediatric patients attending Muhimbili National Hospital, Dar Es Salaam, Tanzania. Afr J Urol. 2023; 29:11.

14. Rodriguez MM. Congenital Anomalies of the Kidney and the Urinary Tract (CAKUT). Fetal PediatrPathol 2014;33(5-6):293–320 doi: 10.3109/15513815.2014.959678. [PubMed: 25313840]

15. Jain S, Chen F. Developmental pathology of congenital kidney and urinary tract anomalies. Clin Kidney J 2018;12(3):382–99 doi: 10.1093/ckj/sfy112. [PubMed: 31198539]

16. Solomon BD, Raam MS, Pineda-Alvarez DE. Analysis of genitourinary anomalies in patients with VACTERL (Vertebral anomalies, Anal atresia, Cardiac malformations, Tracheo-Esophageal fistula, Renal anomalies, Limb abnormalities) association. Congenital anomalies 2011;51(2):87–91 doi: 10.1111/j.1741-4520.2010.00303.x. [PubMed: 21235632]

17. Fernandez N, Escobar R, Zarante I. Craniofacial anomalies associated with hypospadias. Description of a hospital based population in South America. Int Braz J Urol 2016;42(4):793–7 doi: 10.1590/S1677-5538.IBJU.2015.0568. [PubMed: 27564292]

18. Agopian AJ, Evans JA, Lupo PJ. Analytic Methods for Evaluating Patterns of Multiple Congenital Anomalies in Birth Defect Registries. Birth Defects Research 2018;110(1):5–11 doi: 10.1002/bdr2.1115. [PubMed: 28925590]

19. Gazdagh GE, Wang C, McGowan R, Tobias ES, Ahmed SF, Study DDD. Cardiac disorders and structural brain abnormalities are commonly associated with hypospadias in children with neurodevelopmental disorders. Clin Dysmorphol 2019 doi: 10.1097/MCD.0000000000000275.

20. Nissen KB, Udesen A, Garne E. Hypospadias: Prevalence, birthweight and associated major congenital anomalies. Congenit Anom (Kyoto) 2015;55(1):37–41 doi: 10.1111/cga.12071. [PubMed: 25040012].

21. San Agustin JT, Klena N, Granath K, et al. Genetic link between renal birth defects and congenital heart disease. Nature communications 2016;7:11103–03 doi: 10.1038/ncomms11103

.

Downloads

Published

2026-05-16

How to Cite

1.
A. Almunaifi S, El Emmawie AH, U Tak M, A. Bayoumi M, H A Hassan M. Hypospadias in Neonates: Associated Renal and Extra-Renal Anomalies Identified Through Routine Ultrasound Screening in a Tertiary NICU. J Neonatal Surg [Internet]. 2026 May 16 [cited 2026 May 17];15(1s):102-6. Available from: https://jneonatalsurg.com/index.php/jns/article/view/10299

Issue

Vol. 15 No. 1s (2026): Journal of Neonatal Surgery

Section

Original Article

License

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

You are free to:

  • Adapt — remix, transform, and build upon the material for any purpose, even commercially.

Terms:

  • Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.
  • No additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.