[Issues inherent to the management of disorders of sex development in Point G Hospital]. / Problématique de la prise en charge des anomalies de la différenciation sexuelle dans le service d'urologie : CHU Point G.

Abnormal sexual development causes unconformity between gender identity and gender role. In countries with low socio-economic level, the optimal management is difficult. The aim of this study was to evaluate the frequency, the genital anatomy appearance, the diagnostic and the surgical management of disorders of sex development (DSD) discovered during the adolescence. Between January 2005 and November 2006 (23 months), five patients with abnormal sexual development were identified in Point G Hospital. First-line testing included biology measurement and imaging. A surgical management was systematically offered. Median age was 19.5±11.8 years (6-31). All patients were initially assigned male. Sexual dimorphic with genital ambiguity was the first reason of consultation (three children to five). One patient had male breast development and one had pelvic pain. All clinical evaluation suggested genital ambiguity. The diagnostic was female pseudohermaphrodism in three cases, true hermaphrodism in one case and hypogonadism for one patient. A masculinizing genital surgery was performed in three cases. The other patients refused the treatment or were out of sight. Intersex disorders are relatively rare in Mali with a prevalence of 2.30‰ in our hospital. This study highlighted the lack of financial means and local resources for optimal clinical management of individuals with DSD.

[Exstrophy of the bladder in adults]. / Exstrophie vésicale chez l'adulte.

The authors present the case of a 39-year-old male patient, married and assumed to be the father of 4 children, who presented with bladder exstrophy. The patient, living in Mali, never came to consultation for this disease. The review of the literature allows defining the consequences for adults of this condition, which is now operated in childhood in most cases.

[Cancer of the kidney revealed by massive tumoral invasiveness of the testis. Apropos of a case in a child]. / Cancer du rein révélé par un envahissement tumoral massif du testicule. A propos d'une observation chez l'enfant.

The authors report about the unusual evolution of Wilms' tumor in a 3-year-old child, characterized by a very extensive retrograde invasion of the testis, far larger than the primary tumor arising from the upper pole of the right kidney. This evolution is particularly unusual for this type of tumor.