Penoscrotal Positional (PSP) Anomalies

  • Mohamed Fahmy


Normal penoscrotal configuration, with the penis overriding the scrotum with its characteristic skin rugae stoping at the base of the penis without creeping and with a preserved angle had a paramount impaction in the psychic satisfaction of a child, but usually this not the case in all children, as partial or complete positional exchange between the penis and scrotum diagnosed infrequently as a rare anomaly which may be manifested in different phenotypes, and minor degree may pass unnoticed, but it may be associated with other genitourinary anomalies. Many pediatric surgeons and urologists believe that this minor positional anomaly is not harmful and usually asymptomatic, but investigating those children and adults who had such abnormality revealed a urinary symptoms in the form of abnormally directed stream, and increased frequency of UTI and they may had a difficulty during intercourse, which may impact their sexual life.


Cephalic scrotal transposition Central median penile scrotalization Caudal scrotal regression Wide penoscrotal angle Scrotal engulfment Shawl scrotum Prepenile scrotum 

Supplementary material

Video 15.1

(MP4 947 kb)


  1. 1.
    Fahmy MAB, Alaa Aldin A, Alshennawy AA, Edress AM. Spectrum of penoscrotal positional anomalies in children. Int J Surg. 2014;12(9):983–8. Scholar
  2. 2.
    Appleby LH. An unusual arrangement of the external genitalia. Can Med Assoc J. 1923;13:514–6.Google Scholar
  3. 3.
    Mcllvoy DB, Harris HS. Transposition of the penis and scrotum: case report. J Urol. 1955;73:540–3.Google Scholar
  4. 4.
    Lamm DL, Kaplan GW. Accessory and ectopic scrota. Urology. 1977;9:149–53.CrossRefPubMedGoogle Scholar
  5. 5.
    Wang MH, Baskin LS. Endocrine disruptors, genital development, and hypospadias. J Androl. 2008;29:499–505.CrossRefPubMedGoogle Scholar
  6. 6.
    Takayasu H, Ueno A, Tsukada O. Accessory scrotum: a case report. J Urol. 1974;112:826–7.PubMedGoogle Scholar
  7. 7.
    Sule JD, Skoog SJ, Tank ES. Perineal lipoma and the accessory labioscrotal fold: an etiological relationship. J Urol. 1994;151:475–7.PubMedGoogle Scholar
  8. 8.
    Blaschko SD, Mahawong P, Ferretti M, et al. Analysis of the effect of estrogen/androgen perturbation on penile development in transgenic and diethylstilbestrol-treated mice. Anat Rec (Hoboken). 2012;296:1127–41 [PubMed: 23653160].CrossRefGoogle Scholar
  9. 9.
    Lage JM, Driscoll SG, Bieber FR. Transposition of the external genitalia associated with caudal regression. J Urol. 1987;138:387–9.PubMedGoogle Scholar
  10. 10.
    Glenn JF, Anderson EE. Surgical correction of incomplete penoscrotal transposition. J Urol. 1973;110:603–5.PubMedGoogle Scholar
  11. 11.
    Meguid NA, Temtamy SA, Mazen I. Transposition of external genitalia and associated malformations. Clin Dysmorphol. 2003;12:59–62.CrossRefPubMedGoogle Scholar
  12. 12.
    Forshall I, Rickham P. Transposition of the penis and scrotum. Br J Urol. 1956;38:250–2.CrossRefGoogle Scholar
  13. 13.
    Pinke LA, Rathbun SR, Husmann DA, Kramer SA. Penoscrotal transposition: review of 53 patients. J Urol. 2001;166:1865–8.CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing Switzerland 2017

Authors and Affiliations

  • Mohamed Fahmy
    • 1
  1. 1.Pediatric SurgeryAl Azher UniversityCairoEgypt

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