Long-Term Surgical Outcome of Masculinizing Genitoplasty in a Large Cohort of Patients With Disorders of Sex Development (DSD)

Abstract

Purpose To evaluate the results of masculinizing genitoplasty in a large cohort of DSD patients treated at a single public tertiary center. Material and Methods We evaluated 65 patients (57 with 46,XY DSD and 8 with 46,XX DSD reared as males) with proximal Hypospadias and genital ambiguity that were submitted to surgery from 1965 to 2008. The mean follow-up was 15.1±10 years and the average age at the last examination was 25.9±14.1 years. Cosmetic result and urinary stream were objectively evaluated and questionnaires were applied inquiring about urinary and sexual symptoms and self-satisfaction with surgical results. Results Cosmetic results were good in 44%, regular in 53% and poor in 3% of the cases. Mean penile length at last clinical evaluation in postpubertal patients was 7.8 ±2.4 cm (-6.5 to -1.5 SDS). Mean penile length at diagnosis was smaller in the 5αRD2 deficiency group compared to undetermined 46,XY DSD group (p Conclusions Although 85% of the patients were satisfied, specific complaints about penis size, sexual activity or urinary symptoms were frequent. New approaches should be developed to achieve full satisfaction of DSD patients in adulthood.