Penoscrotal Transposition: Causes, Symptoms, and Treatment
Medically reviewed by Harsha Moole, MD, Internal Medicine. Last reviewed: October 2, 2026.
What kind of doctor treats Penoscrotal Transposition?
A pediatric urologist, a urologist who treats children, usually manages this condition. A family doctor or pediatrician often makes the first referral. Because the condition can come with other differences, some children also see a kidney doctor or a genetics doctor.
What it is
Penoscrotal transposition is a rare birth difference in which the penis sits in an unusual place, often between or below the two halves of the scrotum, the pouch of skin that holds the testicles. In a typical body, the scrotum sits below and behind the penis; with this condition, the two areas are switched or shifted.
Symptoms
The main sign is the unusual position of the penis and scrotum, noticed at birth. Some babies also have an abnormal opening of the tube that carries urine out of the body, or undescended testicles. The condition itself does not usually cause pain.
Causes and who gets it
Doctors do not fully know what causes it. It happens before birth, when the genitals do not form in the usual way. It can appear alone or as part of a larger pattern of birth differences, and some cases have been linked to other syndromes.
How doctors diagnose it
Diagnosis usually starts with a physical exam at birth. Doctors may order imaging tests, such as an ultrasound, to check the kidneys, bladder, and urinary tract. Genetic testing can show if the condition is part of a larger syndrome.
Treatment
Treatment is usually surgery. A urologist, a doctor who specializes in the urinary tract and male reproductive organs, can move the penis and scrotum into more typical positions. Surgery is often done in stages during infancy or early childhood. Many children need follow-up care and treatment for related problems.
When to see a doctor
Most cases are found at birth, so parents usually do not need to look for signs. If a baby is born with genitals that look different from what is typical, the care team will examine the baby and may order tests. Contact a doctor if an older child has pain, swelling, or urination problems.
How a direct primary care or concierge doctor fits in
A direct primary care doctor charges a flat monthly fee instead of billing insurance, while a concierge doctor usually charges more and often works alongside insurance. Either type can be a helpful first contact, examining a newborn and referring the family to a pediatric urologist. After surgery, they can handle follow-up visits and coordinate with the specialist.
Common questions
Does penoscrotal transposition affect fertility?
It can, depending on the person. Some people with this condition also have undescended testicles or other differences that may affect fertility. A urologist can evaluate each person's situation, and results differ from person to person.
Is the condition dangerous?
The position of the penis and scrotum itself is not usually dangerous. The concern is that it can come with other differences in the urinary tract or kidneys. Doctors use tests to check for these related problems.
Can it be fixed with surgery?
Surgery can move the penis and scrotum into more typical positions. Many children do well after surgery, but results differ from person to person. Some children need more than one procedure.
How common is it?
It is rare, and exact numbers are hard to find because it often occurs along with other conditions. Most doctors will see only a few cases, if any, during their careers.
Sources
- NIH Genetic and Rare Diseases Information Center - Penoscrotal transposition
- National Organization for Rare Disorders (NORD) - penoscrotal transposition - National Organization for Rare Disorders
Medical Disclaimer
This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.
