Avaliação do desempenho sexual após cirurgias corretivas de genitália ambígua

This study evaluated the sexual performance of patients with genital ambiguity that had been submitted to corrective genitalsurgery. It was done a survey among the patients with genital ambiguity, undergone surgical correction, now aged 16 years oldor older and who had already initiated a sex life of a university clinic of intersexuality. Later, it was applied the Golombok RustInventory of Sexual Satisfaction (GRISS). Twenty patients who fulfilled the inclusion criteria: age older than or equal to 15 yearsold and submitted to surgical correction were selected. Of those, only four patients had begun their sex life. Several problemsrelating to sexuality were identified: Low frequency of relations, inappropriate sexual communication, sexual dissatisfaction,and sexual avoidance, lack of expression of sensuality, Vaginism and anorgasmia. Among those difficulties, the “low frequencyof relations” has been detected in all patients. It was detected that sexual function is altered in patients undergoing correctivegenital surgery. However, we can not say whether this is due to the basic pathology or if it is a sole consequence of the surgicalcorrection. This survey asks whether there is a negative effect resulting from corrective surgery of the genitalia, no sexual futureperformance of these patients. It questions also what the most propitious time to perform the surgery is: if in early childhoodor during adolescence.A ambiguidade genital atinge em torno de 1/20000 nascidos vivos na América Latina, e as repercussões psicossexuaisdesse evento ressaltam a necessidade de aprofundamento nesse tema. Este trabalho teve por objetivo avaliar odesempenho sexual de pacientes intersexuais com ambiguidade genital, submetidos à cirurgia genital corretiva.Participaram da pesquisa quinze pacientes femininas, portadoras de ambiguidade genital, submetidas à clitoroplastiaredutora, atualmente com idade igual ou superior a dezesseis anos, de um serviço universitário especializado emintersexualidade. Foi aplicado o GRISS, um questionário de avaliação da função sexual, às quatro pacientes que haviaminiciado vida sexual, das quinze pacientes contatadas. Foram notificados diversos problemas relativos à sexualidade.Todas as pacientes tinham pouca frequência do intercurso sexual e evitação sexual, e três delas expressaram falta deexpressão do desejo sexual e insatisfação sexual. Observou-se que a função sexual está alterada em pacientes submetidasà correção genital cirúrgica, porém não se pode afirmar se isso é consequência exclusiva da correção cirúrgica, ou decorrenteda patologia de base

Clinical profile of 93 cases of 46, XY disorders of sexual development in a referral center

ABSTRACT The term DSD refers to disorders that affect the normal process of sexual development causing disagreement between chromosomal, gonadal and phenotypic sex, and this study aimed to describe the clinical profile of a group with DSD 46, XY joined on DSD Clinic of Hospital of Salvador, Bahia Clinics. It was a retrospective study of medical records of survey data of 93 patients with DSD 46, XY. Among the patients studied 50.5% had no defined etiology and 20.4% had androgen insensitivity syndrome (AIS), 63.4% had been initially recorded in males, 31 (33.3%) in females, being that in two it was necessary to reassignment. All patients with complete AIS pure gonadal dysgenesis and had female genitalia. Others have been diagnosed with genital ambiguity or severe hypospadias and cryptorchidism. The gonads were palpable at the first consultation in 75.3% of patients. It is important to establish an active surveillance program for these patients. The first assessment took place before the age of ten in more than 50% of cases, which shows that much needs to be done for medical education and community about the DSD. Because the phenotypic variability of sexual development disorders was noted that the clinical profile of patients studied ranged between different etiologies, including hindering the diagnostic conclusion of these individuals