Background Elastosonography analyses the variable elasticity of a tissue by recording the changes of RF pulses from a structure, before and after manual compression.

The aim of this study is to apply the elastosonography on normal and hypospadic penis to verify the structural differences in tissues composition and stiffness.

Materials and methods 28 subjects were enrolled, mean age 24 months: 17 patients on post-operative follow-up for distal hypospadia and 11 age-matched subjects as control group. Elastosonography recorded antero-posterior and transverse diameters of the cavernous corpora, urethral and corpus spongiosum diameters, elastographic index of elasticity of the corpus spongiosum. The latter was defined as soft, medium-hard or hard. We assigned the value 1 to soft tissue, 2 and 3 to medium-hard and hard respectively.

All scan were performed at the base of the penis, as far as possible from the region involved in the surgical procedure.

Results Average antero-posterior and transverse diameters of the cavernous corpora were 4.2 mm (DS 0.83) and 6.5 mm (DS 1.12) for hypospadic group and 7.3 mm (DS 1.28) and 9.0 mm (DS 1.67) for control group. These data showed statistically significant difference between the two groups for both the diameters (p < 0.05).

Corpus spongiosum diameter was 1.9 (DS 0.33) for hypospadic group and 2.7 mm (DS 0.73) for control group (p < 0.05).

Elastography showed a corpus spongiosum stiffness defined as medium-hard or hard in all cases of the pathologic group and soft in all the subjects of the control group (p < 0.05).

No significant difference was found for urethra diameter between the two groups.

Conclusions Elastosonography showed how the hypospadia anatomy is deeply altered, even in an anatomical area far from meatal abnormality: corpus spongiosum in hypospadic penis seems to be globally stiffer and less elastic.

Moreover, cavernous corpora are less developed.

These preliminary results suggest the feasibility of the elastosonography for the evaluation of hypospadic penis. It could be useful during surgical plan to have a better definition of the calibres and quality of the tissues, especially in proximal hypospadia.

We believe that this methodic could also be important during the early post-operative follow-up.