178 / 330
178
28
TH
CONGRESS OF THE ESPU
RESULTS
Testes were identified in 5 children: 4 mutations of AR gene (p.F755V, p.W752G, p.F584del,
p.S204N+p.R615del) and one of SRD5A2 gene (p.Q126R+p.Y253F). One ovotestis was also found
(46XX-DSD). Overall the incidence of DSD in “female” neonate with inguinal hernia is lower than
expected (1,9%), even when focusing on cases with bilateral surgery and a simple persistence of
the peritoneovaginal channel (3,5%). In case of bilateral hernia with digestive content (n=48), the
incidence raises to 12,5%. Patients with persistent gonadal exteriorization (n=19) represent the
group with the highest risk of underlying DSD (31%).
CONCLUSIONS
The incidence of DSD among “girls” undergoing unilateral or bilateral hernia repair is low and
depends on the exact phenotype. The simple persistence of the contralateral channel is not a risk
factor for an underlying DSD. Systematic research of CAIS or SRD5A2 mutations may be justified
in selected patients only, especially those with gonadal content on both sides.
S16-8 (P without presentation)
IS NERVE SPARING CLITOROPLASTY REALLY A NERVE
SPARING?
Haytham BADAWY
1
, Ashraf SAAD
2
, Dina ABDALLAH
3
, Shaymaa ELSAYED
4
,
Doaa KHATER
4
and Magdy OMAR
4
1) University of Alexandria, Ped-urology, Alexandria, EGYPT - 2) University of Alexandria, Urology, Alexandria, EGYPT
- 3) University of Alexandria, Pathology department, Alexandria, EGYPT - 4) University of Alexandria, Endocrinology
department, Alexandria, EGYPT
PURPOSE
Surgery for clitoral reduction has been practised for over half a century. The aim of clitoral surgery is
to achieve normal clitoral morphology without compromising sexual function. To achieve these pur-
poses, many techniques were developed since Young first reported reduction clitoroplasty in 1937.
As the importance of the neurovascular bundle was realized, attempts were made to preserve this
structure aiming at preservation of the sensory supply to the clitoris to achieve sexual satisfaction.
MATERIAL AND METHODS
The study was conducted on 6 patients with congenital adrenal hyperplasia, who were operated
upon with reduction clitoroplasty with neurovascular bundle preservation as a part of the genital
reconstruction between January2014 and December 2015.The study protocol was approved by the
Human Ethics Review Committee of the faculty of medicine and assigned consent form was ob-
tained from each subject. Whole surgically removed corporal bodies were processed. Examination
of the sections was done for the presence of nerve bundles related to the anatomical location of the
neurovascular bundle.
RESULTS
Thick nerve bundles were seen in the dorsal aspect of the corporal bodies embedded in the fibrous
tissue of the tunica albuginea related to the anatomical location of the neurovascular bundles.
CONCLUSIONS
Despite of neurovascular bundle preservation during the reduction clitoroplasty procedure, it is
inevitable to destroy a considerable part of the nerve supply to the clitoris thus causing sensory
defect which may cause sexual dissatisfaction.