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True hermaphrodite with bilaterally descended ovotestes
INTERNATIONAL
ABSTRACL9
171
OF PEDIATRIC SURGERY
described. A voiding cystourethrogram demonstrated the presence of anterior urethral valves; the operation performed to excise these is described.-B. M. Henderson. CONGENITAL ANTWOR URETHRAL VALVE-DLKNOSIS AND TREATMENT. J. Daniel, A. M. Stewart, and D. W. Blair. Brit. J. Urol. 40, 589-591 (October) 1968. A case of a 6-year-old boy with an anterior urethral valve is recorded. The upper urinary tract was normal on intravenous urography. The valve was excised by open operation. Y-V plasty at the bladder outlet was performed in addition since the authors were of the opinion that there was coincident bladder neck obstruction.-,I. H. Johnston. COMPLETE AWLSION OF THE ANTERIOR URETHRA IN A BOY: REPORT OF A CASE WITH SUCCESSFUL RECONSTRUCTION.M. N. Al-Ghorab, and A. P. EZ-Badawi. J. Urol. 100:32-25 (July) 1968. The case of a IO-year-old boy who sustained perineal trauma is presented. The perineal urethra had been divided and in attempting to pass a catheter distally the anterior urethra was avulsed. This was reconstructed using scrotal skin and later Dennis-Browne hypospadias repair. The authors suggest that repair of the urethra following trauma should be delayed until the effects of trauma have subsided and that catheterization of the distal urethra in the presence of extravasation may be attended by further damage as occurred in this case.-B. 21f. Henderson. REPEATED TORSION CAUSING CYSTIC DEGENERATION OF INTRA-ABWMINAL TESTIS. E. S. Glen. Brit. J. Surg. 55:651-652 (September) 1968. A case of repeated torsion of an intra-abdominal testis in a g-year-old boy, ending in cystic degeneration of the testis is reported. Following excision of the cystic (benign) mass he made an uneventful recovery. The relationship of malignant change in an intra-abdominal testis to torsion is discussed briefly.-.I. .I. Corkery. MALIGNANT SERTOLI CELL OF THE TESTIS. R. V. Rosvoll, and J. R. Woodward. Cancer 22:8-13 (July) 1968. Although common in dogs, this tumor is unusual in man. It arises in testicles, ovaries, and occasionally in other sites and has a mixed histologic pattern. They are feminizing lesions and on the few occasions when urinary androgens, estro-
gens, and pregnanetriol have been measured they were elevated. The case of an 8-year-old boy with a sertoli cell tumor of the testis which had been present for 3 years is presented. There were associated retroperitoneal metastases-B. Ar. Henderson. TRUE HEHMAPHRODITE WITH BILATERALLY DESCENDEDOVOTESTES.E. C. McDaniel, M. Nadel, and W. C. Woolverton. J. Urol. 100:77-81 (July)
1968.
The case of a I4-year-old Negro is described who was seen because of progressive breast enlargement and was found to have “abnormal testes” palpable in the scrotum. The child was brought up as a boy but stopped taking part in sports because of the enlargement of his breasts. There was biphid ventral raphe of the penis which was elevated into ridges which joined in the frenullar area. The superior half of the gonads was round and firm while the lower half had the consistency of normal testes. No vas could be felt on either side and there was a prostate of normal size. At laparotomy no female structures were found apart from a pink nodule on the dome of the bladder which was made up of endometrical epithelium and stroma. As it was decided to continue raising him as a male, the ovarian portion of the ovotestes was excised. The authors note that only 5 of the reported cases in the literature have normal male external genitalia ,\1. Henwith both gonads in the scrotum.-B. derson. CONGENITAL ADHENAL HYPERPLASIA. Maria I. New. Pediat. Clin. N. Amer. 15:395408 (May) 1968. Cliteroplasty or clitorectomy must he considered before one year of age, if the phallus is markedly enlarged or if the more modestly enlarged clitoris is disturbing to the parents. With slight clitoral enlargement, without offense to parent or patient, operation may be delayed until puberty, at which time the normal growth of pubic hair and labia majora provide a good camouflage for the slightly enlarged clitoris. Repair of the urogenital sinus should be reserved until just before marriage, since early repair will not persist, and repeated procedures then become neccssary.-A. M. Salzberg.
MUSCULOSKELETAL
SYSTEM
WRINGER INJURIES IN CHILDREN. James
E. Allen,
ABSTRACL9
171
OF PEDIATRIC SURGERY
described. A voiding cystourethrogram demonstrated the presence of anterior urethral valves; the operation performed to excise these is described.-B. M. Henderson. CONGENITAL ANTWOR URETHRAL VALVE-DLKNOSIS AND TREATMENT. J. Daniel, A. M. Stewart, and D. W. Blair. Brit. J. Urol. 40, 589-591 (October) 1968. A case of a 6-year-old boy with an anterior urethral valve is recorded. The upper urinary tract was normal on intravenous urography. The valve was excised by open operation. Y-V plasty at the bladder outlet was performed in addition since the authors were of the opinion that there was coincident bladder neck obstruction.-,I. H. Johnston. COMPLETE AWLSION OF THE ANTERIOR URETHRA IN A BOY: REPORT OF A CASE WITH SUCCESSFUL RECONSTRUCTION.M. N. Al-Ghorab, and A. P. EZ-Badawi. J. Urol. 100:32-25 (July) 1968. The case of a IO-year-old boy who sustained perineal trauma is presented. The perineal urethra had been divided and in attempting to pass a catheter distally the anterior urethra was avulsed. This was reconstructed using scrotal skin and later Dennis-Browne hypospadias repair. The authors suggest that repair of the urethra following trauma should be delayed until the effects of trauma have subsided and that catheterization of the distal urethra in the presence of extravasation may be attended by further damage as occurred in this case.-B. 21f. Henderson. REPEATED TORSION CAUSING CYSTIC DEGENERATION OF INTRA-ABWMINAL TESTIS. E. S. Glen. Brit. J. Surg. 55:651-652 (September) 1968. A case of repeated torsion of an intra-abdominal testis in a g-year-old boy, ending in cystic degeneration of the testis is reported. Following excision of the cystic (benign) mass he made an uneventful recovery. The relationship of malignant change in an intra-abdominal testis to torsion is discussed briefly.-.I. .I. Corkery. MALIGNANT SERTOLI CELL OF THE TESTIS. R. V. Rosvoll, and J. R. Woodward. Cancer 22:8-13 (July) 1968. Although common in dogs, this tumor is unusual in man. It arises in testicles, ovaries, and occasionally in other sites and has a mixed histologic pattern. They are feminizing lesions and on the few occasions when urinary androgens, estro-
gens, and pregnanetriol have been measured they were elevated. The case of an 8-year-old boy with a sertoli cell tumor of the testis which had been present for 3 years is presented. There were associated retroperitoneal metastases-B. Ar. Henderson. TRUE HEHMAPHRODITE WITH BILATERALLY DESCENDEDOVOTESTES.E. C. McDaniel, M. Nadel, and W. C. Woolverton. J. Urol. 100:77-81 (July)
1968.
The case of a I4-year-old Negro is described who was seen because of progressive breast enlargement and was found to have “abnormal testes” palpable in the scrotum. The child was brought up as a boy but stopped taking part in sports because of the enlargement of his breasts. There was biphid ventral raphe of the penis which was elevated into ridges which joined in the frenullar area. The superior half of the gonads was round and firm while the lower half had the consistency of normal testes. No vas could be felt on either side and there was a prostate of normal size. At laparotomy no female structures were found apart from a pink nodule on the dome of the bladder which was made up of endometrical epithelium and stroma. As it was decided to continue raising him as a male, the ovarian portion of the ovotestes was excised. The authors note that only 5 of the reported cases in the literature have normal male external genitalia ,\1. Henwith both gonads in the scrotum.-B. derson. CONGENITAL ADHENAL HYPERPLASIA. Maria I. New. Pediat. Clin. N. Amer. 15:395408 (May) 1968. Cliteroplasty or clitorectomy must he considered before one year of age, if the phallus is markedly enlarged or if the more modestly enlarged clitoris is disturbing to the parents. With slight clitoral enlargement, without offense to parent or patient, operation may be delayed until puberty, at which time the normal growth of pubic hair and labia majora provide a good camouflage for the slightly enlarged clitoris. Repair of the urogenital sinus should be reserved until just before marriage, since early repair will not persist, and repeated procedures then become neccssary.-A. M. Salzberg.
MUSCULOSKELETAL
SYSTEM
WRINGER INJURIES IN CHILDREN. James
E. Allen,