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Surgical treatment of disorders of sexual development
Published in Mark Davenport, James D. Geiger, Nigel J. Hall, Steven S. Rothenberg, Operative Pediatric Surgery, 2020
Rafael V. Pieretti, Patricia K. Donahoe
A retrograde genitography is performed by occluding the opening of the UGS with the inflated balloon of a size 8 Fr Foley catheter placed outside the meatus and secured in place with tape (Figure 80.1a and b); lateral and oblique images are required. The catheter should be then advanced into the bladder for a voiding cystourethogram (VCUG) (Figure 80.2). In approximately 80% of the cases, the level of confluence of the UGS in relation to the bladder neck and external sphincter can be identified, thus facilitating the planning of the surgical procedure.
Disorders of sexual development
Published in Prem Puri, Newborn Surgery, 2017
Genitography is very useful for the study of vaginal morphology, dimension, and relation to the urethra (Figure 109.4a,b,c). We look for the onset of the vaginal outlet in the urogenital sinus (UGS) with special attention to the proximal urethra to plan the urogenital reconstruction (see surgical treatment below).
Mixed gonadal dysgenesis with an ovotestis on imaging mimicking ovotesticular disorder of sexual differentiation
Published in Baylor University Medical Center Proceedings, 2021
Samantha Fine, Kenneth Ford, Bradley Trotter, Hoang-Kim Le, Matthew Crisp, Jose Santiago, Krista Birkemeier
Imaging evaluation of patients with suspected DSD includes ultrasound, voiding cystourethrogram, genitography, and MRI. These allow for the identification of gonads, internal sex organs, and their anatomical communications. Ultrasound is the first line of imaging, as it is readily available, often adequately defines the anatomy, and does not involve radiation exposure.3 A voiding cystourethrogram and genitography use fluoroscopic imaging and catheterization to evaluate communications between the internal structures and external genitalia. MRI provides a more detailed view of anatomy if not defined by ultrasound and assists in staging of malignancy when present. Laparoscopy obtains tissue to assess the pathology and histology of the internal sex organs.4