Surgical treatment of hermaphroditism: experience with 25 cases. 2009

Zhang Jingde, and Xing Xin, and Guo Entan, and Li Junhui, and Xue Chunyu, and Wang Xiaoyun
Department of Plastic Surgery, Changhai Hospital, Second Military Medical University, Shanghai 200433, China.

This article is a summary of our experience with surgical treatment of 25 patients with hermaphroditism. We treated 25 patients with hermaphroditism since 1985, including 12 with male pseudohermaphroditism, 9 with female pseudohermaphroditism and 4 with true hermaphroditism. Decision on sex reassignment for these patients was made according to their genetic sex, gonad sex, social sex, psychologic sex, and the request of the patients and their relatives. Of the 12 male pseudohermaphrodites, 1 was reassigned with the male sex and penile reconstruction was performed, and the other 11 had a female sex assignment and received undescended testis removal, clitoral reduction, labioplasty of the labia minora and labium majus, and vaginoplasty. Nine female pseudohermaphrodites with female sex assignment underwent clitoral reduction, labioplasty of the labia minora and labium majus, and vaginoplasty. The 4 true hermaphrodites also had female sex assignment, and received such procedures as resection of the ovotestes and undescended testes, clitoral reduction, and labioplasty of the labia minora; resection of the uterus and appendices was also performed in 1 case due to the identification of malignant cells. The reconstructed penis in the patient with male sex assignment had good appearance and allowed normal urination. In patients with female sex assignment, the reconstructed external genitalia had also good appearance and good sensation without obvious contraction. No serious complications occurred in these patients, who were satisfactory with the outcome and reported stable gender identity, and 3 married patients reported normal sexual life. Plastic surgery is still the primary option for correction of hermaphroditism after determination of sex assignment, and satisfactory effect can be achieved by surgical intervention with stable gender identity and minimal complications.

UI MeSH Term Description Entries
D008297 Male Males
D008866 Microsurgery The performance of surgical procedures with the aid of a microscope.
D010053 Ovary The reproductive organ (GONADS) in female animals. In vertebrates, the ovary contains two functional parts: the OVARIAN FOLLICLE for the production of female germ cells (OOGENESIS); and the endocrine cells (GRANULOSA CELLS; THECA CELLS; and LUTEAL CELLS) for the production of ESTROGENS and PROGESTERONE. Ovaries
D010413 Penis The external reproductive organ of males. It is composed of a mass of erectile tissue enclosed in three cylindrical fibrous compartments. Two of the three compartments, the corpus cavernosa, are placed side-by-side along the upper part of the organ. The third compartment below, the corpus spongiosum, houses the urethra. Glans Penis,Penis, Glans
D002648 Child A person 6 to 12 years of age. An individual 2 to 5 years old is CHILD, PRESCHOOL. Children
D002987 Clitoris An erectile structure homologous with the penis, situated beneath the anterior labial commissure, partially hidden between the anterior ends of the labia minora.
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000293 Adolescent A person 13 to 18 years of age. Adolescence,Youth,Adolescents,Adolescents, Female,Adolescents, Male,Teenagers,Teens,Adolescent, Female,Adolescent, Male,Female Adolescent,Female Adolescents,Male Adolescent,Male Adolescents,Teen,Teenager,Youths
D012734 Disorders of Sex Development In gonochoristic organisms, congenital conditions in which development of chromosomal, gonadal, or anatomical sex is atypical. Effects from exposure to abnormal levels of GONADAL HORMONES in the maternal environment, or disruption of the function of those hormones by ENDOCRINE DISRUPTORS are included. Disorders of Sexual Development,Sex Development Disorders,Sex Differentiation Disorders,Ambiguous Genitalia,Genital Ambiguity,Hermaphroditism,Intersex Conditions,Intersexuality,Pseudohermaphroditism,Sexual Development Disorders,Sexual Differentiation Disorders,Ambiguities, Genital,Ambiguity, Genital,Condition, Intersex,Conditions, Intersex,Differentiation Disorder, Sex,Differentiation Disorder, Sexual,Differentiation Disorders, Sex,Differentiation Disorders, Sexual,Disorder, Sex Differentiation,Disorder, Sexual Differentiation,Disorders, Sex Differentiation,Disorders, Sexual Differentiation,Genital Ambiguities,Genitalia, Ambiguous,Intersex Condition,Intersexualities,Sex Development Disorder,Sex Differentiation Disorder,Sexual Development Disorder,Sexual Differentiation Disorder

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