Penoscrotal Transposition

Abstract

Penoscrotal transposition (PST) is a rare congenital genital anomaly in which the scrotum is positioned lateral to and above the penis. It may result from arrested caudal migration of the labioscrotal folds which lie lateral to the genital tubercle early during development. When this is associated with underdevelopment of the median raphe, PST will be associated with bifid scrotum. PST may be partial, complete, or associated with bifid scrotum in perineal hypospadias. It is recommended to delay the correction of PST to a second stage after correction of hypospadias in order not to interfere with the blood supply of the penile skin or fascial flaps during the hypospadias operation. The principle of surgical correction is to make two triangular incisions, including the scrotal skin on either side of the penis that are mobilized downward and sutured together below the penis in the midline.