The prostate gland volume in boys with hypospadias based on transabdominal ultrasound

Development of both the external genitalia and the prostate gland is influenced by androgens produced by the fetal testes. This raises a question whether abnormal development of the external genitalia is also accompanied by abnormal development of the prostate.

Comparison of the prostate size in boys with various degrees of hypospadias, with special attention to the presence of Müllerian structures Ms in relation to age reference values.

During the prospective study transabdominal ultrasound TUS of the prostate was performed in 522 Caucasian boys, aged 1-17 years (mean 9.73 years). Among them, 126 patients with hypospadias were selected for the presented analysis (mean 9.67 years). They were divided into 3 groups: mild hypospadias MH (n-53), severe hypospadias SH (n-48), hypospadias with persistent Müllerian structures HMs (n-25). Results were compared with current norm standards prepared at the same center.

For boys aged 1-4 y.o., the mean prostate volume MPV in patients with MH was 0.63 ml, with SH 0.57 ml, compared to the norm of 0.66 ml. In this group there was no patient with HMs. In the group of 5-10 y.o MPV in patients with MH was 1.22 ml, with SH 0.86 ml, with HMs 0.49 ml, compared to the 1.04 ml. In 11-12 y.o., MPV in patients with MH was 1.92 ml, with SH - 1.26 ml, with HMs - 0.70 ml, versus 2.62 ml. In 13-15 y.o MPV was 7.72 ml in patients with MH, 8.52 ml with SH and 2.28 ml with HMs versus a 8.41 ml. In 16-17 y.o MPV was 10.53 ml in patients with MH, 10.59 ml with SH, 5.63 ml with HMs versus the norm of 11.50 ml. Results after ANOVA p-value comparing control group to 3 hypospadias groups and Dunnett's test corresponding to comparison of HMs group to control group, p-value indicated that two age groups show significantly smaller prostate (5-10; 13-15; p-value - 0.012; 0.024 respectively). In 16-17 y.o. Group a possible trend toward significance was found (p-value - 0.054). In 11-12 y.o. Group p-value was 0.182.

All pediatric patients with hypospadias without Ms had prostate volumes that did not significantly deviate from the norm. It was found that prostate volume in boys with HMs was significantly smaller in two age groups and may have trended toward significance in another of the four groups studied. Such a relationship has not yet been described.