1, male pseudohermaphroditism
1 male external genitalia type
2. The external genitalia looks like a human rather than a human.
3. Female pseudohermaphroditism and true hermaphroditism with testicular feminization syndrome
Step 2 deal with
1 The younger the sex, the better. Generally, it is necessary to clarify the gender at the age of 2-3.
Gender orientation should be determined by combining social gender, psychological gender, physiological gender and the wishes of parents and patients themselves.
The surgical treatment of hermaphroditism is mainly external genitalia plastic surgery, including Tintin plastic surgery, female private parts plastic surgery, hypospadias repair, female private parts labial plastic surgery, and female private parts external orifice expansion surgery.
Surgical treatment of male pseudohermaphroditism Male genitalia should be plastic according to male sex, only Tintin straightening and urethroplasty are needed. The female internal genitalia on the cryptorchidism side should be removed without affecting the male reproductive tract. If the external genitalia looks like a man, the sex should be determined according to the development of Tintin and testicles, and the external genitalia should be shaped according to men or women. Female genital plasty was performed after bilateral testicles were removed in patients with feminized testicles.
5 female pseudohermaphroditism female genital hypertrophy should be operated as soon as possible. The ventral part of the enlarged female private parts was removed, and only the dorsal 1/3 female private parts and the neurovascular bundles connected with them were preserved, and the female private parts were plastic sutured. If the external orifice of female private parts is narrow, the upper opening of female private parts is enlarged after incision, and the labial flap or pudendal thigh flap is transferred and inserted to repair the wound.
6 true hermaphroditism, as a male sex, should remove ovarian tissue, remove fallopian tube, uterus and enlarged breast at the same time, and close female private parts after peeling off mucosa; If it is a woman, it is necessary to remove testicular tissue, and the enlarged female private parts should be reduced and shaped.
3. Androgyny diagnosis
1. True hermaphroditism
The external female private parts show the male and female reproductive organs, and the testes can be touched in the labia. It is not difficult to diagnose menstrual cramps. When it is difficult to distinguish it from pseudohermaphroditism, gonadal biopsy is feasible. True hermaphroditic gonads have two kinds of gonadal tissues.
2. Pseudohermaphroditism
(1) Male pseudohermaphroditism has an XY chromosome and a testis, and must have female internal or external genitalia, such as female privates blindness, fallopian tubes or uterus. Androgen secretion is normal.
(2) The chromosome of female pseudohermaphroditism is XX, the female private parts are obviously enlarged, the posterior commissure of labia is too long, the perineum is widened, and the figure is short. Endocrine examination showed that urine-17 ketosteroids and pregnancy triol were increased, and plasma testosterone was also significantly increased, which could be used for diagnosis.