Adult outcomes of urinary, sexual functions and fertility after pediatric management of differences in sex development: Who should be followed and how?

Nicolas Kalfa, Josefin Nordenstr��m, Gunter De Win, Piet Hoebeke
Author Information
  1. Nicolas Kalfa: D��partement de Chirurgie Infantile, Service de Chirurgie Visc��rale et Urologie P��diatrique, CHU de Montpellier, Montpellier, France; Centre de R��f��rence Maladies Rares DEVGEN Constitutif Sud, CHU de Montpellier, Montpellier, France; UMR 1302 Institute Desbrest of Epidemiology and Public Health, INSERM, Univ Montpellier, Montpellier, France. Electronic address: nicolaskalfa@gmail.com.
  2. Josefin Nordenstr��m: Department of Pediatric Surgery/Urology, Sahlgrenska University Hospital, Gothenburg, Sweden.
  3. Gunter De Win: Department of Urology, University Hospital Antwerp, Edegem, Belgium; Astarc, Faculty of Medicine and Health Science, University of Antwerp, Belgium; Adolescenty Urology, University College London Hospitals, London, UK.
  4. Piet Hoebeke: Department of Urology, Ghent University Hospital, Gent, Belgium.

Abstract

The management of Differences of Sex Development (DSD) has evolved considerably in recent years. The questioning of systematic early childhood treatment of DSD requires a better understanding of the outcomes of such treatments and long-term studies are therefore essential to better evaluate the prognosis of DSD. Unfortunately, limitations are numerous including the limited size of the series, the absence of standardized methodology, the evaluation of managements that no longer take place today and the absence of prospective and comparative studies. Despite these difficulties, the purpose of this paper is to present the current data on the long-term follow-up of patients with DSD from the urological, sexual and fertility points of view. Even if it remains difficult at present to establish precise recommendations, we recapitulate the most important points that should drive follow-up of these patients especially the constitution of a multidisciplinary team with a holistic approach, the organization of the transition between adolescence and adulthood, a particular attention to psychological care, a careful communication with the patients and his/her family and the use of standardized data collection systems.

Keywords

MeSH Term

Humans
Disorders of Sex Development
Adult
Fertility
Male
Female
Child
Adolescent
Follow-Up Studies

Word Cloud

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