Penoscrotal Transposition

Abstract

Penoscrotal transposition (PST) was reported for the first time by Appleby in 1923 [1]. PST is an extremely rare congenital malformation in which the scrotum is positioned superior and anterior to the penis. PST results from abnormal genital tubercle development around the 6th week of gestation [2]. It is associated with delay in the midline fusion of the urethral folds. Although the occurrence of the most reported cases of PST has been sporadic, other congenital anomalies such as hypospadias, chordee, and renal agenesis or dysplasia could be found in approximately 90 % of patients [3]. Gastrointestinal abnormalities, predominantly imperforate anus, were found in 30 % of cases [4]. Growth deficiency and mental retardation have also been noticed in 60 % of patients [5]. Differential diagnosis must include pseudohermaphroditism, penoscrotal hypospadias, micropenis, intrauterine penile amputation, and especially penile agenesis with a midline skin tag anterior to the anus [2].