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S13-8
(P)
DIGIT LENGTH IN HYPOSPADIAS AND UNDESCENDED TESTES
Linda SHORTLIFFE
1
, Hsi-Yang WU
2
, Erik KOUBA
2
, Winifred OWUMI
2
and Michael HSIEH
2
1) Stanford University, Urology; Pediatric Urology, Stanford, USA - 2) Stanford University, Urology, Stanford, USA
PURPOSE
Digit length ratio has been reported to differ between sexes, and hypothesized to correlate with in utero testosterone
exposure. Since in utero hormone levels are difficult to obtain, we examined digit and anogenital ratios in boys with
hypospadias and undescended testes as a potential surrogate measure.
MATERIAL AND METHODS
With institutional approval, boys undergoing hypospadias, orchiopexy, circumcision, hernias, and hydroceles were
identified. Under anesthesia before operation, digital calipers measured the lengths of 2
nd
and 4
th
digits of both hands
(L24, R24) and the anogenital distance (AS anoscrotal, AP anopenile). Inter and intraobserver measurement variables,
L24, R24 and AS:AP ratios were determined.
RESULTS
204 patients were entered with 130 evaluable; circumcision, hydrocele/hernia (N=31), undescended testes (N=52) and
hypospadias (N=47). Intraobserver variation for boys <2 years age was 4.4%, >2 9%; interobserver variation was
16.4% and 9% respectively. For overall groups (circumcision, hydrocele/hernia vs. undescended testes vs hypospadias)
there were no differences in digit ratio or anogenital length. When stratified by age and severity, boys with mid to
penoscrotal or proximal hypospadias had shorter anogenital ratio (AS:AP) than boys with hydroceles/hernias
(midhypospadias 0.301±0.091, penoscrotal and lower 0.318±125 vs 0.404±0.076 p=0.006, p=0.047 respectively), but
no difference among digit ratios.
CONCLUSIONS
We were unable to determine differences between digit ratios among boys with circumcision, hydroceles, undescended
testes, or hypospadias. In hypospadias > 2 years the AS:AP ratio was decreased compared to those with undescended
testes or hydroceles and hernia. Whether factors such as prematurity or in vitro fertilization, affect the digit ratio need
further evaluation.