Female Development UROGENITAL TRACT Female Development RICHARD SCHLUSSEL, M.D. DEPARTMENT OF UROLOGY...

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UROGENITAL TRACT Female Development Female Development RICHARD SCHLUSSEL, M.D. DEPARTMENT OF UROLOGY DIVISION OF PEDIATRIC UROLOGY

Transcript of Female Development UROGENITAL TRACT Female Development RICHARD SCHLUSSEL, M.D. DEPARTMENT OF UROLOGY...

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UROGENITAL TRACT

Female DevelopmentFemale Development

RICHARD SCHLUSSEL, M.D.

DEPARTMENT OF UROLOGY

DIVISION OF PEDIATRIC UROLOGY

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• Normal development

• Duplication

• Agenesis

• UG Sinus

• Imperforate hymen

• CAH

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• Paramesonephric duct– A.K.A. Mullerian Duct– Becomes future

• Fallopian tubes

• Uterus

• Upper 2/3 vagina

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VAGINAL AND UTERINE DUPLICATION

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Bicornuate Uterus

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Didelphys uterus

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Unicornuate Uterus

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Complete Vaginal Duplication

• Symptom– Blood persists despite

tampon during menses

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• Symptom– Upper vagina fills

with blood during menses

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Mayer-Rokitansky-Küster-Hauser Syndrome

1 in 5,000 births

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VAGINAL AGENSIS

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Normal Hymenal Ring

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Imperforate hymen

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Imperforate hymen

Mucous due to maternal hormones

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Intra-op drainage of imperf hymen

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Ambiguous Genitalia

• Female Pseudohermaphrodite– Congenital Adrenal Hyperplasia (CAH)

• 46 XX• Normal ovaries, uterus and upper vagina• Virilized external genitalia

– Due to in utero exposure to testosterone

• Most common cause of intersex

• Normal potential for sexual and reproductive Normal potential for sexual and reproductive function as femalesfunction as females

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Ambiguous Genitalia

Congenital Adrenal Hyperplasia

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-Nonpalpable testes

-Hypospadias

- small phallus with curvature

-ALERT !!ALERT !!-ALERT !!ALERT !!-ALERT !!ALERT !!

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UROGENITAL SINUS

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UROGENITAL SINUS

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• Association with Urinary Tract Anomalies– Renal agenesis

– Ectopic ureters

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Albert Einstein

• “Imagination is more important than knowledge “

• "The secret to creativity is knowing how to hide your sources."

• “It’s not that I was so smart; I just stayed with a problem longer”

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Hypospadias

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Hypospadias repair

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Hypospadias repair

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CAH 46 XX