TRUE HERMAPHRODITISM - CLINICAL FINDINGS, DIAGNOSTIC METHODS AND TREATMENT

True hermaphroditism is a disorder of sex determination in which ovari an as well as testicular tis sues are present in the same individual. Most patients present at birth with ambiguous genitalia; primary ameno rrhoea, gynaecomastia or hematuria are common symptoms in many patient s during puberty. Physical examination, ultrasonography, hormonal stim ulation tests as well as genetic investigations are needed prior to ex ploratory laparotomy to determine true hermaphroditism. Sex-assignment should be guided by the anatomical aspect. Female true hermaphrodites are often fertil (10 pregnancies have been published), in contrast to infertility of male patients. The prevalence of gonadal tumours is 4. 6% in 283 patients with a higher risk for patients with a 46,XY karyot ype. Thus the removal of the testicular tissue and replacement therapy at puberty is recommended. Surgical treatment in true hermaphrodites includes correction of the external genitalia and resection of the ova rian tissue in male patients.