Ambiguous genitalia: problem and its surgical correction

ABSTRACT

The aim of this work was sex determination and/or surgical correction of patients with ambiguous genitalia with long term follow up. The study included 15 patients with ambiguous genitalia who were classified according to the age of presentation into 2 groups Group I including 12 neonates with ambiguous genitalia and group II including 3 adults complaining of primary amenorrhoea, abdominal masses and/or hypogonadism. Ambiguous genitalia should be considered a neonatal emergency. A delay in diagnosis may expose the patients to salt losing crisis, malignant degeneration of the gonads and development of inappropriate secondary sex characters at puberty. The decision of sex assignment must be taken after considering the future of sexual function, the feasibility of plastic reconstruction, the fertility potential, the risk of gonadal malignancy, the patient's or family wishes and the age at presentation. Any attempt to change the sex beyond the age of 2 years was likely to be complicated by major psychological difficulties