The role of excretory urography in patients with hypospadias

The routine use of excretory urography in asymptomatic patients with hypospadias is still a subject of controversy. In 169 patients with hypospadias we reviewed the indications for urographic evaluation and the radiographic results. Of the boys 67 had signs or symptoms of urological disorders, and 102 were asymptomatic and screened prospectively. Abnormalities in those patients with symptoms were significant, which supports the need to continue evaluating patients in this group radiographically. In those boys screened prospectively the incidence of upper tract abnormalities was low. Reflux was discovered in 10 per cent of these patients, although in the majority it was mild and of no surgical consequence. Over-all, reflux remains the single most common urographic abnormality in boys with hypospadias with or without symptoms.