Aim. To evaluate surgical procedures adopted
for male genitoplasty in intersex disorders.
Patients and Methods. Case records of
intersex patients undergoing male genitoplasty from Pediatric
Intersex clinic were studied. Results. Of 356 intersex cases
undergoing urethroplasty from 1989–2007, the hypospadias was
penoscrotal (68%), scrotal (17%) and perineal (15%). 351 patients
underwent chordee correction for mild: moderate: severe chordee in
24 : 136 : 191 cases. Byars flaps were fixed upto the corona in 267
cases. Urethroplasty performed was Theirsch duplay in 335 cases,
Snodgrass in 16 cases and Ducketts onlay graft in 5 cases that did
not require chordee correction. Age at urethroplasty was 2.5 years—22 years
(mean 11.5 years, median—5.6 years). Penoscrotal
transposition correction and testicular prosthesis insertion were
performed independently. Complications included fistula (45),
recurrent fistula (11), stricture (12), baggy urethra (8) and
recurrent infection due to persistent vaginal pouch (5).
Additional distal urethroplasty was required in 15 patients for
previous urethroplasty done upto the corona 5–15 years earlier.
Conclusion. Hypospadias in intersex disorders is associated with
severe chordee in most cases and requires an early chordee
correction to allow phallic growth, staged urethroplasty and
multiple surgeries to achieve good cosmetic and functional
results