When Hypospadias Becomes a DSD Clue | S5E2

When should hypospadias trigger a DSD evaluation?Proximal hypospadias alone is not synonymous with a difference of sex development. But the diagnostic probability changes substantially when the phenotype includes cryptorchidism, bifid scrotum, micropenis, genital asymmetry, or other discordant features.In Season 5, Episode 2 of Pediatric Urology Academy, we examine how to read the genital phenotype across three axes: urethral anatomy, gonadal position, and overall masculinization.The episode explores why bilateral undescended testes with severe hypospadias should move the clinician beyond reconstructive planning toward endocrine and genetic reasoning; why unilateral cryptorchidism represents a more nuanced diagnostic zone; and why descended testes reduce—but do not eliminate—the possibility of an identifiable molecular diagnosis.The central principle: phenotype changes probability; it does not establish etiology.Pediatric Urology AcademySeason 5 — DSD, Cryptorchidism and the Undescended GonadHosted by Amin Afrasiabi, MDEducational content for healthcare professionals. Not individual medical advice.