Paediatric surgical principles in the management of children with intersex

Two children, one with dysgenesis of the gonads and chromosomes 46XY and one with true hermaphroditism, are described. The principles of therapy with special reference to the operative correction of the external genitalia are discussed. One child was made a male and the other a female. The diagnostic procedure, heredity, hormonal status, chromosome analysis, histology of the gonads, radiological investigations, and skeletal age will partly determine the future sex, as will the decision of the parents and sociological aspects. The sex must be determined as early as possible. In girls, operative corrections should be performed at the time when their own oestrogen and gestagen production is starting. In boys enlargement of a micropenis can be produced by careful administration of testosterone.