Measurement of pudendal evoked potentials during feminizing genitoplasty: technique and applications

We report on 6 patients (average age 13 months) with ambiguous genitalia who underwent stimulation of the dorsal neurovascular bundle of the phallus during feminizing genitoplasty. Three patients had the adrenogenital syndrome, 1 underwent removal of a masculinizing adrenal tumor before genital reconstruction, 1 had mixed gonadal dysgenesis and 1 had male pseudohermaphroditism. Stimulation of the dorsal neurovascular bundle with measurement of electromyographic nerve conduction latencies was performed before and after ligation of the corporeal bodies and excision of the erectile tissue. In all 6 cases electromyographic responses were preserved after phallic reduction. Our study clearly shows that modern techniques of genital reconstruction allow for preservation of nerve conduction in the dorsal neurovascular bundle and may permit normal sexual function in adulthood.