Ovotesticular disorder of sex development: Approach and management of an index case in the Dominican Republic Journal Article


Authors: De Jesus Escano, M. R.; Mejia Sang, M. E.; Reyes-Mugica, M.; Colaco, M.; Fox, J.
Article Title: Ovotesticular disorder of sex development: Approach and management of an index case in the Dominican Republic
Abstract: Disorders of sex development (DSD) are a group of congenital conditions associated with anomalous development of internal and external genital organs. Ovotesticular disorder of sex development (OT-DSD) is a condition in which a child is born with both testicular tissue (that possesses variable fertility potential within seminiferous tubules) and ovarian tissue (with primordial follicles). These tissues may be co-existent in the same gonad (ovotestis) or independently in separate gonads. Here, we report the clinical case of a 21-month-old boy that we met during a humanitarian surgical mission performed at Hospital Dr. Francisco Moscoso Puello, Santo Domingo, Dominican Republic. The child was referred for management of hypospadias, cryptorchidism, and symptomatic right inguinal and umbilical hernias. With further chromosomal evaluation, the diagnosis of SRY-negative OT-DSD was made, and shared decision-making was used to determine the timing of gender assignment, reconstruction, and the child's long-term care team. OT-DSD is an uncommon condition with unclear causes. Once a DSD condition is suspected at birth, a complete investigation should be performed, encompassing a descriptive examination, a basic electrolyte and hormonal profile, genetic assessment, and pelvic ultrasound. Consultation with a multidisciplinary team is warranted, including pediatric urology or pediatric surgery with urologic training, endocrinology, genetics, psychology, pathology, and the patient's pediatrician at minimum before surgical reconstruction. It is crucial to involve the patient and their family with shared decision-making before surgery or gender assignment.
Keywords: genetics; sexual dysfunction; diagnosis; development; ambiguous genitalia; disorder of sexual; ovotestis; dsd position paper
Journal Title: Cureus
Volume: 13
Issue: 10
ISSN: 2168-8184
Publisher: Cureus Inc.  
Date Published: 2021-10-05
Start Page: e18512
Language: English
ACCESSION: WOS:000709733700015
DOI: 10.7759/cureus.18512
PROVIDER: wos
PMCID: PMC8526082
PUBMED: 34692261
Notes: Article -- Source: Wos
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