In twin pregnancies the incidence of congenital abnormalities is greater than in singleton ones. This is true especially in monozygotic ones. The higher incidence of hypospadias in monochorionic twins has already been described and so also the association between hypospadias and heart anomalies. We examined the case of a couple of twins both affected by hypospadias, whose clinical history represents an example of association between minimal anomalies of cardiovascular system and hypospadias in twins. The first fetus had first degree hypospadias and unique umbilical artery. The second fetus presented first degree hypospadias and bilateral cryptorchidism. In the first twin, who featured bilateral cryptorchidism, echocardiogram was normal. In the second baby echocardiogram had been diagnosed oval forame patency. The uniqueness of the clinical case we reported is due to the association of a concordant urogenital malformation (phenotypically identical first degree hypospadias) with an anomaly of cardiovascular apparatus, different in the two infants (single umbilical artery in a twin and oval forame patency in the other), in two dichorionic twins.
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