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Paper Information

Title: 

INTERSEX: REPORT OF 30 CASES, ETIOLOGY AND SURGICAL RESULTS

Type: PAPER
Author(s): IMANI B.*,SADIGHI GILANI M.A.,MEHRABAN DARAB
 
 *
 
Name of Seminar: CONGREH ANJOMAN UROLOGY IRAN
Type of Seminar:  CONGRESS
Sponsor:  ANJOMAN OROLOGY
Date:  2005Volume 8
 
 
Abstract: 

PROPOSE: GENITAL AMBIGUITY IN A NEW BORN IS A CONCERNING STATE AND ALSO A MEDICAL EMERGENCY. EARLY MANAGEMENT WILL PREVENT PSYCHOLOGIC DISORDERS, ANDROGENIZATION OF FEMALE NEW BORN BRAIN, LIFE THREATENING STATES (CAH, GONADAL TUMORS) AND INCREASE FERTILITY RATE. INTERSEX IS A RELATIVELY RARE DISORDER, SO THERE IS FEW STUDY WITH ENOUGH CASES AND FULL WORK UP IN THE LITERATURE. WE REPORT THE RESULTS OF DIAGNOSTIC AND TREATMENT PROCESS IN 30 INTERSEX PATIENTS.
METHODS & MATERIALS: FROM 1997 TO 1999, A PROSPECTIVE, DESCRIPTIVE STUDY WAS DONE ON 30 PATIENTS IN URO-ENDOCRINOLOGY DEPARTMENT OF SHARIATY HOSPITAL. PHYISICAL EXAMS, KARYOTYPE, HORMONAL ASSESSMENT, SONOGRAPHY AND IF NECESSARY SRY, GENITOGRAPHY, ENDOSCOPY, IVP, LAPAROSCOPY OR LAPAROTOMY WERE DONE. THREE PATIENTS WERE LOST TO FOLLOW UP (TWO OF THEM HAD BEEN SEVERELY DEPRESSED AFTER DIAGNOSIS). IN THE REST 27 PATIENTS, THE AVERAGE FOLLOW UP WAS 10 MONTHS.
RESULTS: THE MEAN AGE WAS 16 YEARS OLD. THERE WAS A SIGNIFICANT STATISTICAL DIFFERENCE BETWEEN THE AGE OF DIAGNOSIS WITH BIRTH LOCATION (HOME VERSUS HOSPITAL) AND WITH PARENTS EDUCATION (P< 0.05). THE DIAGNOSIS WERE: MALE PSEUDOHERMAPHRODITISM IN 15PATIENTS, FEMALE PSEUDOHERMAPHRODITISM IN 10, TRUE HERMAPHRODITISM IN 1, PURE GONADAL DYSGENESIS IN 1 AND 3 PATIENTS WERE UNCLASSIFIED. THE NUMBER OF SURGICAL PROCEDURES WERE 25 AND THERE WAS 1 COMPLICATION: URETHROCUTANEOUS FISTULA AFTER HYPOSPADIAS REPAIRE. ALL OF THE PATIENTS (OR THEIR PARENTS) WERE SATISFIED BY SURGERY AND 4 PATIENTS HAD NORMAL SEXUAL FUNCTION AFTER TREATMENT.
DISCUSSION & CONCLUSION: THE MEAN AGE OF THE PATIENTS ARE ELDER THAN EXPECTED (ABOVE 14 YEARS IN 50%). BESIDES EARLY DIAGNOSIS, THE SURGEON SHOULD BE AWARE OF ALL TREATMENT OPTIONS AVAILABLE AND IN THIS CASE, THE COMPLICATIONS WILL BE THE LESS.

 
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