Intersex: diagnosis and management

The determination of the gender in a neonate is a social emergency. The different types of sexual ambiguities are mainly recognized at birth. However, some cases present at a later age. This study presents the experience of the Pediatric Surgical Unit, University of Alexandria in the domain of sexual ambiguity. The total number of the series accounted for 73 patients; 41 had major degrees of hypospadias with transposition and /or bifid scrotum and needed various types of urethroplasties, orchiopexy and scrotoplasty with transposition. Twelve patients were females with adrenogenital syndrome and a large clitoris and needed clitoridoplasty. Ten cases with mixed gonadal dysgenesis with mosaicism and multiple cell lines needed masculinizing and feminizing genitoplasties according to the dominant cell line and the status of the phallus. and lastly, 10 cases with testicular feminizing syndrome. The final decision was taken after counseling and assessment of the genotype, phenotype and the sex of rearing

Retropubic bladder neck placation: a new simple technique for the management of incontinent epispadias in males

Proximal penile and penopubic male epispadias as well as female epispadias are associated with incontinence of urine. Many techniques had been devised and executed to correct this problem prior to urethroplasty and glansplasty. These techniques ranged from the surgical reconstruction of the bladder neck, endoscopic injection of Teflon, to the implantation of synthetic prothesis working as bladder neck or urethral shutters. In this paper, a simple technique with great success is presented. It entails simple plication of the bladder neck from a retropubic extraperitoneal approach in the keel fashion. Surgical techniques and results are exposed and discussed