Amibigous genitalia/disorders of sex development (DSD)

Amibigous genitalia or disorders of sex development (DSD) is a sexual development disorder when the baby's genitals become unclear whether male or female. Babies who experience this condition have genitals that are not fully formed.

Amibigous genitalia in infants caused :

• Chromosome abnormalities ➡ occur when a baby experiences deficiency or excess chromosomes in his cell, such as Turner's syndrome and Klinefelter's syndrome.
• Hormonal abnormalities ➡ abnormalities in hormone production or sensitivity of the sexual organs during the womb against these hormones.

Amibigous genitalia does not endanger the lives of sufferers. But, sexual disorders can cause social problems.

Cause.

Causes of amibigous genitalia in men :

• Disorders of testicular development.
• Genetic disorders.
• 5A-Reductase enzyme deficiency which functions in the formation of androgen hormones for the development of male genital organs.
• Insensitivity syndrome to androgens.
• Abnormalities in the testes and testosterone

Causes of genital amibigous in women :

• Consumption of drugs containing androgen hormones by pregnant women.
• Hormonal Imbalance.
• Tumors in pregnant women that produce male sexual hormones.
• Congenital adrenal hyperplasia.

The risk of the fetus having amibigous genitalia is still being studied. It is suspected that family history plays a role in increasing the risk of fetal sexual development abnormalities.

A family history of the disease is thought to increase the risk of the fetus having amibigous genitalia, such as :

• The cause of child deaths is unclear.
• Organ abnormalities.
• Congenital adrenal hyperplasia.
• Infertility.
• No menstruation.
• The growth of excess hair on the face in women.
• Having abnormal physical development during puberty.

The symptoms.

• The labia is closed and swollen so that it feels like a scrotum with the testes.
• Enlargement of the clitoris so that it looks like a small penis.
• Urinary tract hole is located above the clitoris, under the clitoris or in the area of ​​the clitoris.
• Hypospadias.
• An abnormally small penis.
• Urinary opening is located close to the scrotum.
• Loss of one or both testicles of the scrotum or parts of the scrotum suspected.
• The scrotum looks like a labia with cryptorchidism, with or without a small penis.

Diagnosis.

• Medical history of both parents and family.
• Physical examination of the baby to check the structure of genital organs.
• Blood tests to measure endocrine gland hormones, androgen receptors, 5A reductase enzymes and baby's electrolyte conditions.
• Check the chromosomes to determine the genetic sex of the baby.
• Ultrasound.
• X-ray (genitography).
• CT scan.
• Analyzing internal genital tissue (ovarian tissue, testicular tissue or both).

Treatment.

Treatment goals for :

• Sexual function.
• Maintain sexual fertility when adult.
• Maintain social interaction.
• Maintaining psychological conditions.

Genital surgery is performed as a method of treating amibigous genitalia. Surgery is performed to maintain sexual function and form external genital organs so that they appear normal.