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Gonadal morphology in cloacal exstrophy: implications in gender assignment
R I Mathews1, E Perlman, D W Marsh
1Division of Paediatric Urology, James Buchanan Brady Urological Institute, Baltimore, MD 21287-2101, USA.
BJU International
|August 12, 1999
Summary
Testicular histology is preserved in males with cloacal exstrophy despite severe malformations. Early gender assignment and orchidopexy are recommended for selected genotypic males with adequate phallic structures.
Area of Science:
- Pediatric Surgery
- Urology
- Developmental Biology
Background:
- Cloacal exstrophy is a severe congenital anomaly.
- Early gonadectomy and gender reassignment are sometimes performed in males with cloacal exstrophy.
- The impact on testicular histology is not well-documented.
Purpose of the Study:
- To compare testicular histology in males with cloacal exstrophy undergoing early gonadectomy with previously published data.
- To evaluate the impact of cloacal exstrophy on testicular development.
Main Methods:
- Histological evaluation of testicular tissue from males with cloacal exstrophy.
- Comparison with normal testicular histology in newborns.
- Mean age at gender reassignment was 6 months.
Main Results:
- No significant abnormalities in the architecture of the rete testis, epididymis, or vas deferens.
- Increased germ cells observed in some specimens, but clinical significance is unknown.
Conclusions:
- Testicular histology is preserved in males with cloacal exstrophy.
- Congruent gender assignment is appropriate for selected genotypic males with adequate phallic structures.
- Early orchidopexy is recommended in these cases.