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Fetal genital anatomy reconstructive implications
1Department of Urology, University of California School of Medicine, San Francisco 94143-0738, USA.
Purpose:
Genital anomalies are not typically diagnosed and/or treated in utero. Recent reports have focused on the prenatal treatment of congenital adrenal hyperplasia. The normal male and female genitalia anatomy is reviewed with an emphasis on reconstructive implications.
Materials And Methods:
Normal fetal genital anatomy was analyzed by serial immunohistochemical staining and 3-dimensional computer reconstruction.
Results:
The neuroanatomy was analogous in male and female patients, revealing an extensive network of nerves not only at the 11 and 1 o'clock position, but completely surrounding the ventral aspect of erectile bodies. The 12 o'clock position was notable for a lack of nerves which has implications in the design of penile straightening procedures. Ultrastructure of the female corporeal bodies is similar to the male counterpart. Evaluation of a fetal specimen with hypospadias revealed a similar anatomy to the normal penis except at the area of deficient urethral spongiosum.
Conclusions:
Attention to anatomical detail will improve surgical techniques for reconstruction in patients with penile curvature and masculinization of the external genitalia.