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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
All reconstructive procedures must begin with a panendoscopy using a pediatric cystoscope with 0-degree and 30-degree optics (Figure 80.5). High-flow irrigation of the UGS facilitates finding a very small vaginal orifice in the back wall of the UGS; in some cases, there may be only a pinpoint orifice, which can usually be found by probing with a 3 Fr ureteral catheter with a stiffened stent. For surgical planning, one must find the precise location of the confluence point between the vagina and urethra, and judge its relation with the bladder neck and the external sphincter. Those anomalies with the confluence point at or above the verumontanum/external sphincter are considered high, and those below are considered low. Patients with 46,XX DSD, MGD, and ovotesticular DSD, as well as those with 46,XY or 45,X/46,XY MGD have a cervix at the most proximal part of the vagina. Patients with 46,XY DSD have either a small prostatic utricle or a deeper, more generous cavity that has no proximal cervix. The prostatic utricle is characteristically found in the center of a flattened verumontanum, but has no surrounding prostatic tissue. In those patients with a mid-level and high confluence, a Fogarty catheter with a stopcock valve is passed into the vagina and the balloon is inflated; a small Foley catheter is also placed in the bladder, and both are labeled and tied together (see also Figure 80.1a and b).
The Infertile Male
Published in Arianna D'Angelo, Nazar N. Amso, Ultrasound in Assisted Reproduction and Early Pregnancy, 2020
Thoraya Ammar, C. Jason Wilkins, Dean C.Y. Huang, Paul S. Sidhu
Congenital causes of ejaculatory duct obstruction include duct atresia or stenosis as well as compression by midline prostatic cystic lesions, for example, cysts of the prostatic utricle (previously named Müllerian duct cysts), cystic dilatation of the prostatic utricle (PU), and ejaculatory duct cysts [22]. Cystic obstruction of the ejaculatory tracts is usually congenital.
Neoplastic and Non-Neoplastic Lesions in Male Reproductive Organs Following Perinatal Exposure to Hormones and Related Substances
Published in Takao Mori, Hiroshi Nagasawa, Toxicity of Hormones in Perinatal Life, 2020
R. Newbold Retha, John A. McLachlan
In this chapter, recent findings will be presented describing neoplastic and non-neoplastic changes in male mice following prenatal exposure to DES, and the embryological considerations that may result in these abnormalities will be explored. Lesions such as rete testis adenocarcinoma and Müllerian duct lesions will be discussed. Other abnormalities such as undescended and hypoplastic testes, infertility, epididymal cysts, sperm abnormalities, prostatic inflammation, squamous metaplasia of the prostatic utricle, etc. have been covered in a previous review.15 We consider this rodent model to be a system for understanding the influence of perinatal DES exposure in the human male.
Discussion of “Phantom Penis: Extrapolating Neuroscience and Employing Imagination for Trans Male Embodiment”
Published in Studies in Gender and Sexuality, 2020
In our study of alternating gender, several respondents described phantom erections. Several also mentioned altered patterns of arousal and self-stimulation of phantom genitals during their transgender state. For example, during female state, one natal male described arousal focused on the perineum. Speculatively, this may relate to developmental origins of the tissue of the prostate, which can be indirectly stimulated through the perineum or anus (Glickman and Emirzian, 2013). Many researchers believe that the lower two-thirds of the vagina derive from the urogenital sinus (Moore, 1993; though see Kurita, 2010), which in males gives rise (in part) to the prostate (Timms, 2008). The similar developmental origin of the tissues of the lower vagina and prostate suggests possible homologues for cortical representation and sensation of the phantom vagina. Indeed, it has been argued that the prostatic utricle should be called the “male vagina” (Puppo and Puppo, 2016). Perhaps the prostate (or prostatic utricle) could animate the phantom vagina, as the clitoris may animate the phantom penis.
A large retroperitoneal Mullerian cyst: case report and review of the literature
Published in Acta Chirurgica Belgica, 2021
Elena Parmentier, Jody Valk, Paul Willemsen, Caroline Mattelaer
In men, urogenital cysts typically occur in the pelvis. Mullerian duct remnants result from incomplete Mullerian duct regression, urogenital cysts can arise in association with these embryologic remnants. The typical location includes the prostatic utricle.