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Gonadal morphology in cloacal exstrophy: implications in gender assignment
Author(s) -
Ranjiv Mathews,
Elizabeth J. Perlman,
D. W. Marsh,
John P. Gearhart
Publication year - 1999
Publication title -
bju international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.773
H-Index - 148
eISSN - 1464-410X
pISSN - 1464-4096
DOI - 10.1046/j.1464-410x.1999.00148.x
Subject(s) - cloacal exstrophy , epispadias , cloaca , histology , biology , anatomy , bladder exstrophy , rete testis , genitourinary system , sex organ , epididymis , medicine , sperm , genetics , botany
Objective To compare the histology of gonads excised from males with cloacal exstrophy (the most severe variant of the exstrophy‐epispadias complex) undergoing early gonadectomy and gender reassignment (to obviate difficulties in reconstructing male external genitalia) with those published previously. Patients and methods Testicular tissue was obtained from males with cloacal exstrophy undergoing gender reassignment shortly after birth. Slides were stained for histological evaluation and reviewed by one author. The histology was compared with known normal features for newborn testicular tissue. The mean age at the time of gender reassignment was 6 months. Results There were no significant abnormalities in the architecture of the rete testis, epididymis or vas of the study specimens. There were more germ cells in some patients with cloacal exstrophy, but this finding was not specific and is of unknown clinical significance. Conclusions Despite the severity of the malformations in cloacal exstrophy, testicular histology is preserved. In highly selected genotypic males who have adequate phallic structures, congruent gender assignment is appropriate and early orchidopexy is recommended.