Clinical_Rounds_in_Endocrinology_Volume_II_-_Pediatric_Endocrinology

299

Prader Stage

a

b

c

Normal I II III IV V Normal

Types of Hypospadias

Glandular

Subcoronal

Distal penile

Midshaft

Proximal penile

Penoscrotal

Scrotal

Perineal

Y

N Y

N Norm

Distal

Mid

Abd

Abs Abs

Abd

Ing Ing

L/S^2 L/S^2

Prox

3

2

1

00

0.5

1

1.5

Labioscrotal

Fusion

Micro

Phallus

Urethral

Meatus

Right

Gonad

Left

Gonad

External Masculinisation Score

Fig. 9.3 ( a ) Staging to grade the degree of virilization of external genitalia in a 46,XX individual.
( b ) External masculinization score to grade the degree of undervirilization of external genitalia in
a 46,XY individual. ( c ) Grading of hypospadias

features associated with genital ambiguity independently and is more objective.

EMS score for a normal male external genitalia is 12, whereas for a normal

female external genitalia is 0. Both these scores are shown in the fi gure given

below (Fig. 9.3 ).

9 Disorders of Sex Development