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PubMed2005

Satisfaction and tolerability of combination of lactoserum and lactic acid on the external genitalia in Thai women.

OBJECTIVE: The aims of this study were to assess the user satisfaction and tolerability of a combination of lactoserum and lactic acid on the external genitalia of Thai women. MATERIAL AND METHOD: Women who were over 18 years of age who came to gynecologic outpatient unit at Rajavithi Hospital from November 2004 to January 2005, without clinical manifestations of vulvovaginal irritation or infection were included. The exclusion criteria were women who had allergy to a combination of lactoserum and lactic acid, or any of the components of this product. Clinical history was taken and gynaecological examination was performed. Those who met the eligible criteria were assigned to use one bottle of 150 ml combination of lactoserum and lactic acid on the external genitalia. Fisher's Exact test was used to compare the satisfaction between each group. RESULTS: There were 300 patients equally dividing in 3 groups. Average age was 42.2 +/- 9.8 years. The satisfaction percentage was more than 90 percent according to the evaluation criteria. There was no statistically significant difference between products. The tolerability were high percentage, only 3.3% of the patients used these products less than 7 days. 6 patients (2%) experienced discomfort resulting from these products and no statistically significant difference between products. CONCLUSION: The combination of lactoserum and lactic acid demonstrated the high percentage of satisfaction and tolerability. Only 2% of patients experienced discomfort without any serious discomfort effects.

Adult↗
PubMedDate not supplied

[Climacteric symptomatology: relation with hormone levels and trophic features of the external genitalia].

During the last decade the development of a great amount of knowledge about the menopause has allowed to establish almost standardized hormonal treatments in order to prevent its symptoms and its late sequelae. Nevertheless, up to now the relationship between typical climacteric symptoms and the actual risk of late sequelae has not been assessed. The climacteric symptoms have hence been related to the involutional aspects of the external genitalia and to the levels of the sex steroids and gonadotropin hormones. An inverse relation between neuropsychical manifestations (insomnia, anxiety, depression, reduced memory, reduced libido) and 17-beta-oestradiol and progesterone levels has been shown. On the contrary, FSH and LH levels showed a direct relationship with neurovegetative symptoms. The relationship between the involutional aspects of the external genitalia and the atrophy related and the neuropsychical symptoms shows the need to evaluate these classes of symptoms, which appear to be most related to oestrogen and progesterone deprivation, in decision making toward hormonal replacement therapy.

Adult↗
PubMedDate not supplied

[Correlations between trophism of the external genitalia and hormone levels during menopausal age].

In a case group of 341 perimenopausal women the following signs of reduced trophism of external genitalia have been studied: mons pubis hair rarefaction, pale mucosae, labia minora edge thinning, and labia minora involution, as well as their correlation with age, time lapse after the menopause, and plasma FSH, LH, progesterone and 17-beta-estradiol. Signs of reduced trophism appear to be present even in the younger considered ages, but a positive trend with age is shown. The passage from less than one year inveral from the menopause to one to three years interval shows the most marked increase in the appearance of involutional aspects, but at six years from the menopause one fourth of the women still show normal trophism of the external genitalia. An inverse relation with 17-beta-estradiol levels is shown for pale mucosae and labia minora edge thinning while the trend of mons pubis hair rarefaction shows no relation with the hormone level. An inverse relation is shown for progesterone levels and the trend of mons pubis hair rarefaction, while for the other signs of reduced trophism the same kind of relation as for 17-beta-estradiol was shown. FSH and LH levels show an inverse relation with "normal" trophism, a direct relation with pale mucosae and labia minora involution, and no relation with mons pubis hair rarefaction and labia minora edge thinning.

Adult↗
PubMed1989

A study of cutaneous lesions of leprosy on male genitalia.

The cutaneous lesions of leprosy on male genitalia were studied. They were found in 2.9% of cases examined in this series. They were seen most commonly in borderline group. It is emphasised that it is not uncommon to find lesions on male genitalia in leprosy.

Adolescent↗
PubMedDate not supplied

Identification of Ahasverus advena (Waltl) (foreign grain beetle) and Ahasverus rectus (LeConte) (Coleoptera: Cucujidae) by micromorphology of adult fragments including genitalia.

Morphological characteristics of dissected fragments from male and female adult beetles of Ahasverus advena (Waltl) and A. rectus (LeConte) are described and illustrated, including original descriptions of the male genitalia of both species. Diagnostic differences are noted among the morphology of the head, antennae, mandibles, labium, tibial leg segments, prothorax, metasternum, and abdominal sternite I, and between the shape and/or setation of the paired lateral lobes, the apical margin of the aedeagus, the internal sac, and the paired 8th and 9th abdominal sternites for the male genitalia.

Animals↗
PubMed1987

Prostaglandin synthesis is independent of androgen levels in rat male genitalia.

We examined the hypothesis that androgens influence prostaglandin (PG) biosynthesis in rat male genitalia. Prostaglandin synthesis was measured on the basis of the amount of prostaglandin released per unit weight of tissue over time. On this basis, castration increased the synthesis rate of radioimmunoassayable PGE2 from 1.3 +/- 2.5 to 7.4 +/- 2.5 ng/mg protein/180 min (P less than 0.01) in slices of prostate gland, and from 8.5 +/- 1.5 to 24.9 +/- 4.1 ng/mg protein/180 min (P less than 0.01) in slices of seminal vesicle, but decreased PGE2 formation from 27.8 +/- 2.0 to 14.3 +/- 1.2 ng/mg protein/180 min (P less than 0.01) in the vas deferens. Castration had no effect on synthesis of PGE2 in slices of renal cortex or liver. The peak effect of castration for each tissue was variable, ranging from 4 to 14 days. Treatment of castrated animals with testosterone reversed the effect of castration on prostatic prostaglandin biosynthesis: control 1.62 +/- 0.26 ng/mg protein/180 min, castrate 6.05 +/- 1.10 ng/mg protein/180 min, and castrate treated with testosterone T 1.72 +/- 0.16 ng/mg protein/180 min. Testosterone administration also decreased PGE2 formation in normal (noncastrate) animals from 1.62 +/- 0.26 to 0.91 +/- 0.23 ng/mg protein/180 min (P less than 0.04). Similar patterns of stimulation or reduction in biosynthesis of PGF2 alpha and 6-keto-PGF1 alpha were also observed. When considered for the whole gland and not per slice, all the differences disappeared. These results demonstrate that the androgenic effect on the male genitalia occurs in a component of the gland that is unrelated to the production of prostaglandins and that prostaglandin synthesis is maintained despite the occurrence of widespread atrophy.

Androgens↗
PubMedDate not supplied

Somatotype of children with gonadal dysgenesis and structural anomalies of genitalia.

The somatotype of 92 children with sexual structural anomalies of whom 28 with female Turner's syndrome, 22 with Klinefelter's syndrome, 20 with adreno-genital syndrome, 14 with hypospadias, 2 with Reinfenstein's syndrome and 6 with feminizing testis was established on the basis of biometric and genetically determined morphologic characteristics (dermatoglyphics, pigment complex). A morphogram utilizing 12 anthropometric and 5 dermatoglyphic parameters was constructed; it can be used in phenotypical differentiation of the anatomo-clinical variants of structural anomalies of the genitalia and gonads. The 12 anthropometric parameters were: weight, stature, height of the head + neck segment, the sternum-symphysis distance, length of arms and legs, the biacromial and bitrochanterian diameters, the circumference of the thorax, abdomen, hips and head. The dermatoglyphic parameters were: the digital delta index, TFRC, a-b ridge count, the ATD angle and the A line obliquity. For longitudinal assessment of the phenotype of children with structural anomalies of genitalia and gonads, the authors propose utilization of the percentile diagrams regarding weight, stature, pubes to floor distance, and the biacromial and bitrochanterian diameters.

Adolescent↗
PubMed1981

Teenagers' preferences regarding the presence of family members, peers, and chaperones during examination of genitalia.

During physical examination that include the genitalia, teenagers are typically separated from their parents and females are provided with a chaperone. To assess teenagers' attitudes regarding this practice, 140 females and 60 males awaiting treatment in a general adolescent clinic were asked their opinion about a physical examination that include the genitalia. Teenagers indicated whether they would want to be accompanied during the examination, and by whom, as a function of the hypothetical clinical situation that varied the sex and familiarity of the physician. Choices reflected teenagers' age and sex, rather than physician characteristics. Young males and females strongly preferred to be accompanied, generally by a family member. With increasing age, males preferred to be alone with the physician whereas females preferred to be accompanied. Regardless of sex and age, virtually none chose the company of peers. Despite strong development differences, however, there also were pronounced individual differences among teenagers of the same age. Our results suggest that service delivery be adapted to the particular preference expressed by individual teenagers. Needs assessment for adolescent programs may best be achieved by conducting similar surveys in local clinical settings.

Adolescent↗
PubMed1995

Operative reconstruction of the external and internal genitalia in female patients with bladder exstrophy or incontinent epispadias.

PURPOSE: Urologists and gynecologists rarely encounter questions on cohabitation and pregnancy in female patients with bladder exstrophy or incontinent epispadias. MATERIALS AND METHODS: Until 1994, 41 female patients underwent surgery at our institution (vaginal cutback or vaginoplasty in 23, correction of the external genitalia in 25 and uterus fixation to correct or prevent prolapse in 13). RESULTS: Followup was available in 37 patients (mean 16.8 years, with followup of 18 years or longer in 19). Of the patients 94% are satisfied with the cosmetic results. All adults engage in sexual intercourse, 4 delivered 6 children by cesarean section and 5 presently desire children. CONCLUSIONS: Fertility in patients with bladder exstrophy or incontinent epispadias is normal, and pregnancy is possible. Patients and parents should be well informed. Besides urinary tract reconstruction, correction of the external and internal genitalia should be discussed in detail.

Adolescent↗
PubMed1984

Tandem dup (1p) within the short arm of chromosome 1 in a child with ambiguous genitalia and multiple congenital anomalies.

A newborn infant was found to have multiple congenital anomalies including bilateral cleft of lip and palate, intrauterine growth retardation, microcephaly, tetralogy of Fallot, ambiguous external genitalia, and presence of male and female internal genitalia. Chromosome analysis showed a tandem duplication of part of the short arm of chromosome 1, resulting in a dup(1p31----35). The karyotype designation is 46,XY,dir dup(pter----31::p35----p31::p31----qter). The exact nature of the chromosome anomaly was clarified with use of several banding methods.

Abnormalities, Multiple↗
PubMed1991

Acute arterial insufficiency of the male genitalia.

Three patients developed severe ischemia of the penis or scrotum from acute arterial occlusion. In one case, nonhealing ulceration of the glans developed after atheroembolism to the dorsal penile artery. One patient had penile ischemia after ligation of pelvic and femoral collateral circulation during repair of an aorto-bilateral-iliac artery aneurysm. A third patient had ischemia of the penis and scrotum from thromboembolism to the iliac arteries during repair of an aortoenteric fistula. Only seven patients have been described with acute arterial occlusion and severe ischemia of the male genitalia. A rare phenomenon because of rich collateral circulation, acute ischemia of the genitalia nevertheless must be recognized as a sign of severe vascular disease and a consequence of major arterial ligation or occlusion in the pelvis and groins.

Acute Disease↗
PubMed1996

Abnormal gonadal differentiation in two subjects with ambiguous genitalia, Mullerian structures, and normally developed testes: evidence for a defect in gonadal ridge development.

Among a group of patients with abnormal sexual differentiation, we have identified two subjects who had a 46,XY karyotype, ambiguous genitalia, and well-developed Müllerian structures, but normal appearing testes. The presence of ambiguous genitalia and persistent Müllerian structures implied both Leydig cell and Sertoli cell dysfunction, hence, gonadal dysgenesis. However, the normal testicular histology suggested that the underlying abnormality was not a defect in testis determination itself but an abnormality in timing of gonadal ridge and testis development. In one of the two subjects genomic DNA was available. The sequence of the SRY gene was normal. Because rare patients with partial androgen insensitivity may have a similar phenotype, the AR gene was evaluated by denaturing gradient gel electrophoresis (DGGE) and was normal. Some subjects with mutation of the WT1 gene or with deletion of the distal short arm of chromosome 9 may have similar phenotypes. The WT1 gene was studied by single-strand conformation polymorphism (SSCP) analysis and was normal. In addition, there was no loss of heterozygosity of polymorphic markers in distal 9p. The gene for Müllerian inhibiting substance (MIS) was also studied by SSCP and was normal. Although the exact mechanism for the defect in the two subjects is unknown, it may be due to an abnormality in a gene or genes involved in the timing of gonadal ridge development.

Cell Differentiation↗
PubMed2005

Female genitalia hydatidosis herniating to the inguinal canal.

Hydatid disease of the female genitalia presents a rare problem in gynecology formerly limited to only a few parts of the world. Primary pelvic hydatidosis is uncommon, and its pathogenesis remains unclear. We report one case of primary hydatid cysts and another case of secondary hydatid cysts of the female genitalia that herniated to the inguinal canal.

Adult↗
PubMed1999

Posterior sagittal transanorectal approach in patients with ambiguous genitalia: report of eight cases.

The posterior sagittal transanorectal approach was used for reconstruction of the female genitalia (vaginoplasty) in eight girls with urogenital sinus, high vaginal implantation, and normal rectum, in all cases with a protective sigmoidostomy. These eight patients included four female and four male pseudohermaphrodites. They remain fecally continent, but only seven have urinary continence. One girl has a neuropathic bladder: umbilical discomfort during abdominal straining is present in one patient. One girl married and demonstrated satisfactory sexual intercourse. All patients are alive and healthy, physically and mentally. The transanorectal approach allows separation of the vagina from the urethra and bladder, provides good vaginal mobilization down to the perineum, avoids the utilization of perineal skin flaps and sometimes a laparotomy, and preserves defecation and urinary control. The cosmetic appearance of the genitalia seems to be better than that achieved in the past with other techniques.

Adolescent↗
PubMed1998

Congenital lymphoedema of the genitalia.

UNLABELLED: Isolated congenital lymphoedema of the external genitalia in boys is extremely rare. It can have major physical and emotional consequences for the children. Three male patients with primary lymphoedema of the penis and scrotum are described. The first case presented with lymphoedema of the prepuce and the phallic skin that persisted after the age of 1 year. Circumcision and excision of the subcutaneous tissues of the phallic skin were successful in producing the appearance of a normal circumcised penis. The second case presented with oedema of both phallic and scrotal skin. At age 1 year only a pastous thickening of the prepuce remained, scrotal and phallic skin normalised spontaneously. Routine circumcision was successful with a 5-year follow up. The third case presented with persistent oedema of both the scrotum and the phallus. He suffered leakage of lymph requiring incontinence pads, with complicating skin infections recurring every 4-6 weeks at age 8 years. After complete peeling of the scrotal and phallic skin from subcutaneous tissue some leakage persisted, infections subsided. The cause of this disorder remains unknown, although hypoplasia of the lymphatic vessels is reported in most cases. In the literature, several congenital malformations have been associated with primary lymphoedema. These were not noted in our patients. Rarely, the lymphoedema regresses spontaneously. The treatment of persistent lymphoedema is surgical and consists of meticulous excision of all subcutaneous layers of the affected skin, combined with reconstruction of the penis and/or scrotum. CONCLUSION: Primary lymphoedema of the male external genitalia is an extremely rare malformation of the lymphatic vessels of unknown origin. If persistent, surgical treatment is necessary.

Genital Diseases, Male↗
PubMed1991

Surgical management of ambiguous genitalia in the infant and child.

Proper gender assignment to a neonate born with ambiguous genitalia is a social emergency of the newborn period. Once an appropriate sex assignment has been made, the next critical step is performance, if needed, of a reconstructive procedure in a timely fashion. In an attempt to evaluate our experience with this unique group of patients, we have retrospectively reviewed the course of 69 children with ambiguous genitalia managed surgically at this institution between 1974 and 1989. This series consists of 32 genotypic females with congenital adrenal hyperplasia (CAH), 10 children with mixed gonadal dysgenesis (MGD), 10 male pseudohermaphrodites, 3 true hermaphrodites, 8 genotypic females with urogenital sinus anomalies (UGS), and 6 genotypic males with bilateral undescended testes and penoscrotal hypospadius. All newborns initially seen at this institution received proper sex assignment within the first week of life. Prior to 1980, 17 of the children with CAH underwent clitorectomy and vaginoplasty and three underwent clitoral recession and vaginoplasty. After 1980, 10 patients with CAH were managed with clitoral recession and vaginoplasty and 2 with vaginoplasty alone. Eight of 10 cases of MGD were given a female sex assignment and all 8 underwent gonadectomy due to the high risk of gonadoblastoma; the other 2 children were raised as males. There were 3 true hermaphrodites of which 2 were assigned female gender roles and were managed with a clitoral recession and vaginoplasty. All 10 male pseudohermaphrodites were raised as females and all underwent bilateral orchidectomy. The 8 children with UGS were raised as females and underwent vaginal reconstruction.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1990

Immunopathology of experimental Brucella abortus strain 19 infection of the genitalia of bulls.

Antibody responses in serum and semen, and immunoglobulin containing cell (ICC) populations in the genitalia of bulls were compared after inoculating Brucella abortus strain 19 into the seminal vesicles of two bulls (ISV route) and into testes in two other bulls (IT route). Bulls seroconverted as early as 1 week post-infection (PI). Peak serum titres as determined by the serum agglutination test (SAT), complement fixation test (CFT) and ELISA occurred at PI weeks 3, 4 and 5 respectively. Highest titres were in IT inoculated bulls. Seminal antibodies against B. arbotus S19 were demonstrated from 2 weeks PI by both the SAT and the Rose Bengal Test (RBT) and highest titres occurred at PI weeks 3 and 4. Examination of immunoglobulins (Ig) in semen, however, revealed no significant differences of Ig isotypes between infected and control animals at any examination time. When bulls were killed at 7 weeks PI, quantitation of ICC in genital sections stained by the peroxidase-anti-peroxidase method revealed an overwhelming predominance of IgG containing cells in inflamed organs. In all cases IgG1- and IgG2-containing cells were prevalent, and present in approximately equal numbers. IgA-containing cells were second in prevalence in inflamed tissues while IgM cells were always in low percentage. High prevalence of ICC in infected genitalia, associated with elevated specific seminal antibodies but not with increased seminal Ig indicates that most Ig remains localised in tissues and is not transferred into genital secretions.

Animals↗
PubMed2006

Sex assignment for newborns with ambiguous genitalia and exposure to fetal testosterone: attitudes and practices of pediatric urologists.

OBJECTIVE: Sex assignment to newborns with ambiguous genitalia is controversial. Our objective was to determine the attitudes and practices of pediatric urologists on this subject. STUDY DESIGN: A survey of fellows in the Urology Section of the American Academy of Pediatrics was completed by 185/228 (81%). The survey referred to two cases, masculinized 46XX congenital adrenal hyperplasia (CAH) and 46XY cloacal exstrophy. Questions referred to sex assignment, timing of surgery, decision making process, and respondent demographics. RESULTS: For masculinized 46XX CAH, virtually all respondents favored female sex assignment. The most important factor was potential fertility. For 46XY cloacal exstrophy, two thirds favored the male sex. The most important factor was potential androgen brain imprinting, whereas in selecting female assignment, it was difficulty creating a functional phallus. Respondent characteristics associated with assigning female sex were longer duration in practice (>15 years) and affiliation with training programs. Most respondents advocated a team approach to decision making with parental involvement and early surgery (<18 months). CONCLUSION: Pediatric urologists are in strong consensus about sex assignment for newborns with ambiguous genitalia from CAH, a team approach with parental involvement, and early reconstruction. Yet, there is striking variability in attitudes toward sex assignment for newborns with 46XY cloacal exstrophy, which should be incorporated into the decision-making process with parents.

Adrenal Hyperplasia, Congenital↗