Update on the surgical approach for reconstruction of the male genitalia

作者：Romao Rodrigo L P; Salle Joao L Pippi

来源：Seminars in Perinatology, 2017, 41(4): 218-226.

DOI：10.1053/j.semperi.2017.03.015

• Hypospadias
• Ambiguous genitalia
• XY DSD
• Intersex
• Male
• Surgery

The majority of patients with DSD will be found to carry an XY karyotype and be assigned male gender. From a phenotypical standpoint, most will present with proximal hypospadias +/- cryptorchidism. In this review article, the authors present the current status of reconstruction of the male genitalia in this setting. The report addresses the following topics: surgical input in the evaluation of the newborn with an undervirilized external genitalia, including gender assignment considerations; controversies surrounding timing and indication for hypospadias surgery in proximal cases as well as use of testosterone; surgical techniques and decision-making process for one- vs. two-stage repairs; complications of hypospadias surgery based on technique used for repair; and long-term follow-up. The high complication rates observed in the treatment of proximal hypospadias attest to its challenging nature. Concentration of experience, tracking carefully identified patient centered outcomes and long-term follow-up of this patient population are recommended.

• 出版日期2017-6