Surgical management of neonates and children with ambiguous genitalia.
Gender assignment is a neonatal surgical emergency. Early evaluation and treatment of intersexuality must be done as a team approach with a genetist, a paediatric endocrinologist and a paediatric surgeon/urologist taking part in it. Change of gender after 2 years of confusion of gender identity often results in social disaster. Over a period of 20 years the authors managed a total of 27 patients with ambiguous genitalia. They favour early reconstruction of most anomalies at about 3 years of age, which seems to be optimal in terms of surgical feasibility and avoidance of the obvious emotional problems caused by delayed intervention. A detailed description of policy and techniques is given for surgical intervention in the patient to be raised as a female or as a male. They changed the gender in three patients, twice in neonates and once before two years of age.
Pintér
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A
University Children's Hospital, Pécs, Hungary.
Kosztolányi
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G
D000293:Adolescent; D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D003558:Cystoscopy; D012734:Disorders of Sex Development / Q000000981:diagnostic imaging / Q000601:surgery*; D005260:Female; D005835:Genitalia / Q000002:abnormalities* / Q000000981:diagnostic imaging / Q000601:surgery; D005836:Genitalia, Female / Q000601:surgery; D005837:Genitalia, Male / Q000601:surgery; D006059:Gonadal Dysgenesis / Q000601:surgery*; D006060:Gonadal Dysgenesis, Mixed / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D007021:Hypospadias / Q000175:diagnosis / Q000601:surgery; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D010348:Patient Care Team; D011859:Radiography; D012732:Sex Determination Analysis