Masculinizing genitoplasty in intersex patients

Area of Science:

• Urology
• Pediatric Surgery
• Endocrinology

Background:

• Male pseudohermaphroditism encompasses a spectrum of disorders affecting sexual development.
• Masculinizing genitoplasty (MPG) aims to create a functional and aesthetically appropriate male genitalia.

Purpose of the Study:

• To evaluate the cosmetic and functional outcomes of masculinizing genitoplasty (MPG) in intersex patients assigned male.
• To assess the complication rates associated with one-stage MPG procedures.

Main Methods:

• A retrospective review of 57 patients undergoing MPG over 20 years.
• Focus on 39 patients who had one-stage MPG using modern surgical techniques (1991-2003).
• Analysis of various underlying conditions, presenting anatomy, surgical techniques (onlay flap vs. tubularization), and outcomes.

Main Results:

• Satisfactory cosmetic and functional results were achieved in 59% of patients after one operation.
• Urethroplasty breakdown occurred in 7% requiring reoperation.
• Urethral fistula developed in 12.8% of cases, necessitating surgical closure.

Conclusions:

• One-stage masculinizing genitoplasty for male pseudohermaphroditism is associated with a notable rate of major complications.
• Performing MPG in early childhood is crucial to prevent significant psychological and social anxiety for the child and parents.