New classification of Penoscrotal Positional Anomalies

Background: Partial or complete positional exchange between the penis and scrotum is a rare anomaly which may be manifested in different
phenotypes. Revision of a wide variant of such anomalies enabled elaboration, classification and shading some light on this rare abnormality.
Objective: To provide a simple classification and scoring of the penoscrotal positional anomalies, which may be helpful for accurate description,
recognition and sorting cases that may deserve surgical correction.
Materials: During the last 14 years, the record data of 14450 babies aged from 1 week to 4 years were assessed and 92 cases of abnormal penoscrotal
positional anomalies of different diversity identified, their hormonal profile, associated anomalies, and other details reviewed.
Results: 92 cases of penoscrotal positional anomalies presented as complete cephalic scrotal eversion in 9 and incomplete in 14. Minor cases are
41 with cephalic scrotal transposition which is bilateral in 21, 13 had midline scrotalization, and another 15 cases had a caudal scrotal regression,
other genitourinary anomalies identified in 78% of cases, mainly with major and bilateral minimal cases. Sex hormonal assay showed insignificant
difference in comparison with a control group, and there were gross chromosomal anomalies in 7 cases.
Conclusion: Penoscrotal transposition classified herein to cranial or cephalic scrotal migration, cranial type subdivided into major and minor where
the last subdivided to bilateral, unilateral or central. A new category of caudal scrotal regression documented and described.