Posterior Type 4 (Hypospadias)

geni_8a_n.jpg: Abnormal external genitals in a boy with a high anorectal malformation already operated. The scrotum is divided and lies even a little dorsally from the penis. geni_8b_n.jpg: On traction of the prepuce the orifice is just recognizable below the tilted glans. geni_8a_n.jpg and geni_8b_n.jpg: The diagnosis is perineal hypospadias which is combined with bifid scrotum and partial penoscrotal transposition. In high anorectal malformations, combined malformations occur in two thirds of the patients; genital anomalies also belong to these combined malformations, such as cryptorchidism and hypospadias.