Location

Philadelphia, PA

Start Date

9-5-2018 1:00 PM

Description

Introduction: With only 20 documented cases, the congenital malformation known as complete extreme penoscrotal transposition with an intact scrotum, midline raphe, and absence of hypospadias is an extremely rare abnormality. Penoscrotal transposition occurs when the scrotum fuses above the penis for a complete abnormality or does not fuse at all for an incomplete abnormality. This failure of the scrotum to descend below the penis occurs during development, when the genital swellings fail to descend below the penis and fuse. The irregularity has been known to follow an X-linked recessive pattern in some cases. In others, it results from a defect of chromosome 13. This disease would have significant clinical implications for a patient in day to day activities, as well as sexually. However, little is known as to whether this transposition impacts spermatogenesis.

Method: Dissection and observations were made from a 72-year-old male as part of a gross anatomy course at Philadelphia College of Osteopathic Medicine, utilizing the methods of the dissection manual. Biopsy of the testes were taken and without further fixation processed for light microscopy, using standard techniques.

Results: Upon dissection, the individual exhibited a complete extreme penoscrotal transposition, with the scrotum fused above the penis in a shawl fashion, with no hypospadias. The tunica albuginea was thickened, fused in the midline, and adhered to the testis. Histology of the testis supports that spermatogenesis was not altered. The organization of the seminiferous tubules and developing germ cells appeared to be normal.

Discussion: Along with the penoscrotal transposition, many abnormalities are typically also present. It was observed that the patient had several hernias, mega colon, and many abdominal adhesions. One interesting anomaly observed during dissection was bilateral fused adductor magnus/adductor longus muscles. As a senior computer analyst, this individual likely had no cognitive or mental impairment, however, his cause of death was due to end stage Parkinson’s disease. Living with this disease would have been very difficult because the patient has virtually no protection of the testis as they are positioned superior to the penis. It would have had significant psychosocial implications for the patient, especially with regard to reproduction and sexual intercourse.

Embargo Period

5-30-2018

COinS
 
May 9th, 1:00 PM

Penoscrotal Transposition: A Cadaveric Review

Philadelphia, PA

Introduction: With only 20 documented cases, the congenital malformation known as complete extreme penoscrotal transposition with an intact scrotum, midline raphe, and absence of hypospadias is an extremely rare abnormality. Penoscrotal transposition occurs when the scrotum fuses above the penis for a complete abnormality or does not fuse at all for an incomplete abnormality. This failure of the scrotum to descend below the penis occurs during development, when the genital swellings fail to descend below the penis and fuse. The irregularity has been known to follow an X-linked recessive pattern in some cases. In others, it results from a defect of chromosome 13. This disease would have significant clinical implications for a patient in day to day activities, as well as sexually. However, little is known as to whether this transposition impacts spermatogenesis.

Method: Dissection and observations were made from a 72-year-old male as part of a gross anatomy course at Philadelphia College of Osteopathic Medicine, utilizing the methods of the dissection manual. Biopsy of the testes were taken and without further fixation processed for light microscopy, using standard techniques.

Results: Upon dissection, the individual exhibited a complete extreme penoscrotal transposition, with the scrotum fused above the penis in a shawl fashion, with no hypospadias. The tunica albuginea was thickened, fused in the midline, and adhered to the testis. Histology of the testis supports that spermatogenesis was not altered. The organization of the seminiferous tubules and developing germ cells appeared to be normal.

Discussion: Along with the penoscrotal transposition, many abnormalities are typically also present. It was observed that the patient had several hernias, mega colon, and many abdominal adhesions. One interesting anomaly observed during dissection was bilateral fused adductor magnus/adductor longus muscles. As a senior computer analyst, this individual likely had no cognitive or mental impairment, however, his cause of death was due to end stage Parkinson’s disease. Living with this disease would have been very difficult because the patient has virtually no protection of the testis as they are positioned superior to the penis. It would have had significant psychosocial implications for the patient, especially with regard to reproduction and sexual intercourse.