Long term outcomes in males with Disorders of Sex Development

Abstract

Purpose

Indications that prenatal action of testosterone in the brain is an important determinant of gender development and improved reconstructive techniques caused a shift in male gender assignments in patients with 46, XY disorders of sex development ( DSD). We report long term outcome data on psychosexual development and sexual function.

Materials and Methods

Physical status of 14 men (mean age 25 years) with DSD was assessed using a structured interview and physical examination. Psychosexual outcome was evaluated by means of questionnaires and compared with a control group of 46 healthy age-matched men.

Results

Thirteen men underwent 1 to 6 (mean 2) genital surgeries. Mean age at first surgery was 2.7 years. The mean penile length was 6.6 cm. All men reported erections and were able to experience orgasms. Ejaculatory dysfunction was reported by 7 men. The patients who were and who were not able to achieve penetrative intercourse had a mean penile length of 7.9 and 4.9 cm respectively. The meatus was glandular in 5, coronary in 7 and at the distal shaft in one patient. Men with DSD were less satisfied with the appearance of their penis and scrotum, but not with total body image, compared to controls. They reported less sexual desire and activities.

Conclusion

outcome in this group of DSD men was poor regarding penile length, ejaculation, satisfaction with external genitalia and frequency of sexual activity. Other aspects like overall body image and psychosexual functioning showed no difference with controls.

http://www.jurology.com/article/S0022-5347(13)03675-6/abstract