Gender Assignment, Reassignment and Outcome in Disorders of Sex Development: Update of the 2005 Consensus Conference.

Background: Societal changes are increasingly moving the conceptualization of gender from a set of binary categories towards a bimodal continuum, which along with the cautious conclusions resulting from the 2005 Consensus Conference influences gender-related clinical work with patients with disorders of sex development.

Objective: This article provides an update of these developments over the past decade along with an overview of pertinent new data.

Conclusion: Considerably more research is needed on larger sample sizes with systematic long-term follow-up to ground the emerging trends in clinical management of the highly diverse disorders of sex development syndromes in a solid empirical basis.

Perceptions of the living dead: An assessment of knowledge and opinions about whole body donation, its process, and willingness to become cadaveric donors in Pennsylvania.

Despite the many important uses for human cadavers, there is a relative shortage of bodies donated to the scientific community in the United States of America. The purpose of this study was to determine the community's perceptions regarding whole body donation and their willingness to become donors. Moreover, we aimed to investigate people's understanding of the process of whole body donation, and examine their opinions regarding its importance.

Self-assessment of anatomy, sexual sensitivity, and function of the labia and vagina.

Patient perceptions of genital esthetics are motivating requests for plastic surgeries that could change sexual sensitivity. There is little information about the sensitivities of labial and introital sites. The aim of this study is to assess the relationship between sexual sensitivity and self-reported sizes of labial and introital sites.

Male circumcision decreases penile sensitivity as measured in a large cohort.

Unlabelled: WHAT'S KNOWN ON THE SUBJECT? AND WHAT DOES THE STUDY ADD?: The sensitivity of the foreskin and its importance in erogenous sensitivity is widely debated and controversial. This is part of the actual public debate on circumcision for non-medical reason. Today some studies on the effect of circumcision on sexual function are available.

Inhibitory effects of 405 nm irradiation on Chlamydia trachomatis growth and characterization of the ensuing inflammatory response in HeLa cells.

Background: Chlamydia trachomatis is an intracellular bacterium that resides in the conjunctival and reproductive tract mucosae and is responsible for an array of acute and chronic diseases. A percentage of these infections persist even after use of antibiotics, suggesting the need for alternative treatments. Previous studies have demonstrated anti-bacterial effects using different wavelengths of visible light at varying energy densities, though only against extracellular bacteria.

Immunocytochemical characterization of pacinian-like corpuscles in the labia minora of prepubertal girls.

Study Objective: To better understand the precise role of sensory corpuscles within the female external genitalia.

Design: After IRB approval, waste tissue samples were obtained from 10 normal girls (aged 2-9 years) who underwent surgery for labial fusion. Immunocytochemistry against protein gene product 9.

A retrospective observational study of enuresis, daytime voiding symptoms, and response to medical therapy in children with attention deficit hyperactivity disorder and autism spectrum disorder.

Introduction: Children with attention deficit hyperactivity disorder (ADHD) show an increased prevalence of enuresis and other daytime voiding symptoms (DVS). There is also some evidence toward an increased prevalence of enuresis among children with autism spectrum disorder (ASD), but with no data available with respect to DVS or response to medical treatment. The aim of this study was to assess enuresis and DVS, along with treatment outcomes, in children with ASD, to aid urological management.

Obstructive ejaculatory duct calculi in a patient with bladder augmentation and myelomeningocele.

Symptomatic ejaculatory duct (ED) calculi, typically composed of uric acid, carbonate apatite and calcium phosphate, or calcium phosphate in the form of hydroxyapatite, are rare occurrences. We report a case of bilateral, large ED calculi in a patient with spina bifida myelomeningocele and an augmented neurogenic bladder. A 25-year-old Caucasian male, not compliant with his urological management, presented with abdominal pain, difficulty in self-catheterization, nausea and vomiting.

Pyospermia in an adult cohort with persistent lower urinary tract symptoms and a history of ablated posterior urethral valve.

Purpose: To assess for the presence of lower urinary tract symptoms and abnormal semen parameters in adults with a history of PUV.

Materials And Methods: The study involved 29 male patients, aged 17-51 (mean 21.5 years), with a history of PUV.

Development and validation of the pregnancy and infant orientation questionnaire.

The purpose of this study was the construction, scaling, and scale validation of a self-report questionnaire assessing biographical information and motivation for pregnancy and infant care in men and women with disorders of sex development or other gender variations of potential clinical relevance. The overall design of the questionnaire and the initial item pool were derived from related clinical and research experience. Collection of pilot data and, where appropriate, scale construction (via principal components analyses) were based on Canadian convenience samples of heterosexual (HET) and non-HET men and women (N = 414).

Detection of RXFP1 receptors in skin biopsies from children with congenital adrenal hyperplasia: a preliminary report.

Objective: Relaxin may potentiate the effect of topical estrogen treatment to eradicate post-incisional scarring in congenital adrenal hyperplasia (CAH) patients undergoing genitoplasty. The aim of this study was to determine whether CAH skin is capable of responding to relaxin.

Patients And Methods: Skin biopsies were obtained from four female CAH patients (aged 2-9 years; Prader 4-5, salt-wasting, 21-hydroxylase deficiency, Caucasian) during routine genitoplasty surgery and screened for relaxin receptors.

Adequacy of sanitization and storage of catheters for intermittent use after washing and microwave sterilization.

Purpose: Clean intermittent catheterization is used to treat neurogenic bladders and it can be adequate to maintain sterile urine. Typically polyvinylchloride, individually packaged catheters are used but they are not intended for repeat use by the manufacturer. Antibacterial soap alone or combined with microwave heating was advocated to decrease pathogens and bacterial residue, which could inoculate the bladder from a colonized catheter.

Giant condyloma with demise secondary to meningococcemia in an infant boy.

Human papilloma virus (HPV) is the most common sexually transmitted disease among adults in the USA; however, the presence of HPV in infants is rare. Condyloma acuminata, a cutaneous, fungating lesion caused by HPV, has a generally mild course that often resolves spontaneously or can be managed both medically and surgically. Typical treatments for condyloma include imiquimoid cream, podofilox gel, podophyllin resin, cryotherapy, laser surgery, tangential shave excision, and electrocautery.

Relaxin's involvement in extracellular matrix homeostasis.

Burgeoning evidence suggests that the hormone relaxin modulates collagen in the extracellular matrix of diverse tissues. In separate lines of study, we provide further substantiation of this hypothesis. Immunofluorescence was used to probe isolated fibroblasts derived from volar oblique ligament explant culture for vimentin, actin, RXFP1, and estrogen receptor beta.

Long-term vaginal sequelae secondary to pediatric pelvic fracture.

Background: Pediatric pelvic fractures often appear radiographically benign despite significant injury to viscera. Vaginal injuries are rare, and therefore require a high index of suspicion.

Case: A 26-year-old female patient who sustained a pelvic fracture in a motorcycle accident at the age of 10 presented with vaginal stenosis precluding sexual intercourse.

Cancer of the neovagina.

Objective: Cancer of the neovagina has been documented, and found to occur at younger ages than cancer of the native vagina. A review of the world literature was performed to evaluate risk based on type of tissue used for replacement or reconstruction of the vagina, as well as signs and symptoms of tumor occurrence and follow-up possibilities for early detection/screening for cancer and precancerous changes.

Method: Comprehensive review of relevant published literature.

Mesorchial testicular torsion: case report and a review of the literature.

Testicular torsion can be extravaginal, intravaginal, or mesorchial. Mesorchial torsion is less well defined and has an atypical presentation. Here we present the case of a 13-year-old with severe, intermittent right scrotal pain, erythema, and a large hydrocele.

Clitoral sexual arousal: neuronal tracing study from the clitoris through the spinal tracts.

Purpose: Although genital tactile stimulation is regarded as a precursor to sexual arousal and a recognized initiator of central nervous system arousal, specific afferent neural pathways transmit sensory stimuli of arousal, beginning at the epithelial level on the clitoris and following the course of arousal stimuli through the central nervous system. Limited knowledge exists of the pathway from the cutaneous receptors of nerves originating in the epithelial tissue of the clitoris and continuing to spinal cord afferents. Such information may contribute to an understanding of sexual arousal, particularly in female vertebrates.

Clitoral sexual arousal: an immunocytochemical and innervation study of the clitoris.

Objective: To further define neural pathways and mechanisms responsible for the arousing properties of the epithelium of the clitoris as well as related neural pathways associated with sexual arousal in a murine model.

Materials And Methods: Adult female C57B1/6 mice were used for gross dissection, facilitated by resin injection of the vascular system, and silver staining, and immunostaining for S-100 and neuronal nitric oxide synthase (nNOS). We also comprehensively reviewed relevant published clinical and histological material from both human and non-human vertebrate studies.

Oestrogen receptors and their relation to neural receptive tissue of the labia minora.

Objective: To assess the cellular distributions of oestrogen receptors alpha and beta (ER alpha and ER beta) and neuronal nitric oxide synthase (nNOS) in the labia minora, as knowledge about ER type and function may clarify the role of oestrogens in vaginal scar formation and improve outcomes in female genital surgery.

Subjects And Methods: Labial samples were taken from 10 girls (aged 2-9 years) who underwent surgery for labial fusion. The waste tissue strips obtained were used for immunohistochemical identification of ER alpha and ER beta, and nNOS in the labia minora.

The gender identity/gender dysphoria questionnaire for adolescents and adults.

The present study reports on the construction of a dimensional measure of gender identity (gender dysphoria) for adolescents and adults. The 27-item gender identity/gender dysphoria questionnaire for adolescents and adults (GIDYQ-AA) was administered to 389 university students (heterosexual and nonheterosexual) and 73 clinic-referred patients with gender identity disorder. Principal axis factor analysis indicated that a one-factor solution, accounting for 61.

The neurophysiology of sexual arousal.

Our understanding of the process and initiation of sexual arousal is being enhanced by both animal and human studies, inclusive of basic science principles and research on clinical outcomes. Sexual arousal is dependent on neural (sensory and cognitive) factors, hormonal factors, genetic factors and, in the human case, the complex influences of culture and context. Sexual arousal activates the cognitive and physiologic processes that can eventually lead to sexual behavior.

Imaging and examination strategies of normal male and female sex development and anatomy.

Over recent years a variety of new details on the developmental biology of sexual differentiation has been discovered. Moreover, important advances have been made in imaging and examination strategies for urogenital organs, and these have added new knowledge to our understanding of the 'normal' anatomy of the sexes. Both aspects contribute to the comprehension of phenotypic sex development, but they are not commonly presented in the same context.

The Recalled Childhood Gender Questionnaire-Revised: a psychometric analysis in a sample of women with congenital adrenal hyperplasia.

We administered the 18-item Recalled Childhood Gender Questionnaire-Revised (RCGQ-R), female version, to 147 adult women with congenital adrenal hyperplasia (CAH) representing three different degrees of prenatal androgenization due to 21-hydroxylase deficiency and to non-CAH controls. A principal components analysis generated three components accounting for 46%, 9%, and 6% of the variance, respectively. Corresponding unit-weighted scales (high scores = feminine) were labeled Gender Role (13 items; Cronbach alpha = .