INTERSEX

CASE REPORT AND REVIEW OF LITERATURE

Abstract

1. A 26-year-old patient, whose main complaint was high grade hypospadia, was revealed by exact examination as male intersex.
The penis was 5cm in length, 1.8cm in diameter. The external urethral orifice opened at the perineo-scrotal region. Another orifice was seen in the urethra, ca. 1.5cm cranial to the external urethral orifice. The urethrogram showed, besides a natural urethra, another posterolaterally running long band.
Abdomino-perineal dissection and histological study revealed a left abdominal testis, oviduct, uterus, vagina, right inguinal testis and vas deferens. The vagina opened into the urethra. The extirpation of the left abdominal testis, oviduct, uterus, vaina and the plastic operation of the anterior urethra of Denis Browne's method were performed.
2. A 19-year-old patient whose complaint was abnormal external genitalia was diagnosed by exact examination as female intersex (Congenital adreno-genital syndrome). The clitoris was 4cm in length. The external urethral orifice opened at the perineum, under which the vaginal orifice was seen. Abdominal exploration and histological study revealed bilateral ovaries and hypoplastic uterus. Urinary 17-KS was 14.0mg per day. After the administration of 20 u. ACTH it was increased to 128.5mg, per day.
The treatment was as follows: The extirpation of great clitoris, injection of 50mg. crtisone and oral administration of 5mg. estrogen per day.
Some observations of literature were made.