Dorsal Penis Cleft (Differential Diagnosis = DD Abnormal External Genitals/Hypospadias)

6-year-old boy with abnormal external genitals. On the dorsal side of the penis a cleft of the glans is visible which is oval-shaped, widened, and continues in the penis shaft. The diagnosis is not hypospadias but a grade 2 epispadias which includes at least the shaft of the penis. The penis is shortened, is pulled in a ventral direction and downward by traction on the dorsally divided prepuce (by the finger at the bottom in the picture). That way, the malformation becomes visible. Epispadias belongs to the bladder exstrophy complex.