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The infant with ambiguous genitalia
ABSTRACTS
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is probably a peripheral resistance to androgen associated with testicular secretion of estrogen. Treatment is castration after feminization has taken place, followed by estrogen therapy.-Edward
J. Berman
The Infant With Ambiguous Genitalia. Ralph E. Moloshok and Joseph M. Kerr. Pediat. Clin. N. Amer. 19:529-542 (August), 1972. Cytogenetic techniques used for diagnosis include the buccal smear, dermatoglyphics, and chromosomal analysis. The terms “hermaphrodite” or “intersex” denote individuals with gonads of one or both sexes with some degree of ambiguous development. If ovaries are present, the individual is classified as a female hermaphrodite; if testes are present, the patient is considered a male hermaphrodite; and if ovary and testis are present, the patient is a true hermaphrodite. In female pseudohermaphroditism virilization occurs from fetal or maternal androgen. Congenital virilizing adrenal hyperplasia is most common. In the “salt-losing form” of the disease, death can occur from hyperkalemia, hyponatremia, and dehydration. In male pseudohermaphroditism the external genitalia may be identical to those of the female pseudohermaphrodite, the male with perineal hypospadias, or the normal female. The last is seen in the “syndrome of the feminizing testes” where masculinization is defective due to “target organ nonresponsiveness,” in turn due to an enzymatic error. In mixed gonadal dysgenesis there is usually phallic enlargement with hypospadias. The gonads consist of a testis on one side and a primitive streak on the other. Studies should be undertaken in the newborn period to permit sex assignment. The “wait and see” approach is deplored.-Edward 7. Berman Congenital Absence of the Penis. R. Saraah and G. Reno. J. Urol. 107:154-155 (January), 1972. A case report
is given of a heterozygotic male second twin born without a penis. The child went into severe renal failure and died several days later. At autopsy, he had bilateral polycystic kidneys, no true urinary bladder, no seminal vesicles, and penile agenesis-S. Kim
A
Rare Congenital Malformation: Nonunion of the Testicle With the Epididymis and the Spermatic Duct. V. Rosenberg and 1. Urea. Brit. J. Urol. 44:499-502 (August), 1972.
The case is described of a Is-yr-old boy who was operated upon for ectopic testis. There was no connection between the testis, which lay at the internal inguinal ring, and the epididymis and vas deferens which were in the scrotum. Orchidopexy was performed with excision of the epididymis-7. H. Johnston Electronic Control of Incontinence: A Critical Review of the Present Situation. L. Edwards and J. Malvern. Brit. J. Urol. 44:467-472 (August), 1972.
The results obtained in a series of 64 patients with urinary incontinence treated by electronic methods are discussed. These include six children under the age of 10 yr. It is suggested that present methods of predicting success are unsatisfactory and that treatment may be equally satisfactory if undertaken in a random manner. Electronic treatment is most likely to succeed in the cases where operation is indicated and is likely to fail in those cases where surgery is also likely to fail. It may provide a useful method of short-term control of incontinence, but, in the long term, it is unlikely to replace conventional methods of treatment.-_l. H. 7ohnston
MUSCULOSKELETAL
SYSTEM
Congenital Dislocations of the Hip-Prognostic Signs and Methods of Treatment, With Results. F. W. Ilfeld, J. O’Hara, G. Robins, J. W. Westin, and M. Williamson. Clin. Orthop. 86:21-27 (July-August), 1972.
A total of 166 patients with primary congenital dislocations of the hip were followed from z to 15 yr. Treatment consisted of early attempted reduction, unless the patient was seen over 1 yr of age, at which point delay was effected to await the appearance of femoral epiphyses. Reduction was then attempted, usually requiring open
95
is probably a peripheral resistance to androgen associated with testicular secretion of estrogen. Treatment is castration after feminization has taken place, followed by estrogen therapy.-Edward
J. Berman
The Infant With Ambiguous Genitalia. Ralph E. Moloshok and Joseph M. Kerr. Pediat. Clin. N. Amer. 19:529-542 (August), 1972. Cytogenetic techniques used for diagnosis include the buccal smear, dermatoglyphics, and chromosomal analysis. The terms “hermaphrodite” or “intersex” denote individuals with gonads of one or both sexes with some degree of ambiguous development. If ovaries are present, the individual is classified as a female hermaphrodite; if testes are present, the patient is considered a male hermaphrodite; and if ovary and testis are present, the patient is a true hermaphrodite. In female pseudohermaphroditism virilization occurs from fetal or maternal androgen. Congenital virilizing adrenal hyperplasia is most common. In the “salt-losing form” of the disease, death can occur from hyperkalemia, hyponatremia, and dehydration. In male pseudohermaphroditism the external genitalia may be identical to those of the female pseudohermaphrodite, the male with perineal hypospadias, or the normal female. The last is seen in the “syndrome of the feminizing testes” where masculinization is defective due to “target organ nonresponsiveness,” in turn due to an enzymatic error. In mixed gonadal dysgenesis there is usually phallic enlargement with hypospadias. The gonads consist of a testis on one side and a primitive streak on the other. Studies should be undertaken in the newborn period to permit sex assignment. The “wait and see” approach is deplored.-Edward 7. Berman Congenital Absence of the Penis. R. Saraah and G. Reno. J. Urol. 107:154-155 (January), 1972. A case report
is given of a heterozygotic male second twin born without a penis. The child went into severe renal failure and died several days later. At autopsy, he had bilateral polycystic kidneys, no true urinary bladder, no seminal vesicles, and penile agenesis-S. Kim
A
Rare Congenital Malformation: Nonunion of the Testicle With the Epididymis and the Spermatic Duct. V. Rosenberg and 1. Urea. Brit. J. Urol. 44:499-502 (August), 1972.
The case is described of a Is-yr-old boy who was operated upon for ectopic testis. There was no connection between the testis, which lay at the internal inguinal ring, and the epididymis and vas deferens which were in the scrotum. Orchidopexy was performed with excision of the epididymis-7. H. Johnston Electronic Control of Incontinence: A Critical Review of the Present Situation. L. Edwards and J. Malvern. Brit. J. Urol. 44:467-472 (August), 1972.
The results obtained in a series of 64 patients with urinary incontinence treated by electronic methods are discussed. These include six children under the age of 10 yr. It is suggested that present methods of predicting success are unsatisfactory and that treatment may be equally satisfactory if undertaken in a random manner. Electronic treatment is most likely to succeed in the cases where operation is indicated and is likely to fail in those cases where surgery is also likely to fail. It may provide a useful method of short-term control of incontinence, but, in the long term, it is unlikely to replace conventional methods of treatment.-_l. H. 7ohnston
MUSCULOSKELETAL
SYSTEM
Congenital Dislocations of the Hip-Prognostic Signs and Methods of Treatment, With Results. F. W. Ilfeld, J. O’Hara, G. Robins, J. W. Westin, and M. Williamson. Clin. Orthop. 86:21-27 (July-August), 1972.
A total of 166 patients with primary congenital dislocations of the hip were followed from z to 15 yr. Treatment consisted of early attempted reduction, unless the patient was seen over 1 yr of age, at which point delay was effected to await the appearance of femoral epiphyses. Reduction was then attempted, usually requiring open