RESPONSIVENESS OF PENIS GROWTH TO LOW VS HIGH-DOSE ANDROGEN STIMULATION IN MALE PSEUDOHERMAPHRODITISM

Background. - The androgen sensitivity test used in male pseudohermaph roditism for clinical assessment of the androgen sensitivity and predi ction of penile development is an important element in choice of gende r. However, there is a wide range of testosterone dosage and no standa rdized test. Methods and patients, - Two doses (25 mg and 100 mg) of t estosterone heptylate were used in six cases of male pseudohermaphrodi sm with sexual ambiguity and small penis (ages 6 to 18 months). The cl inical results were compared with those of the study of androgen recep tors. Results. - In two cases, both low-dose and high-dose tests resul ted in only minimal changes in the penis. In two cases, the low-dose t est gave a good result which was confirmed by the high-dose test; on t he other hand, in two cases, the low-dose test was considered to be ne gative whereas the high-dose lest led to the development of a normal-s ized penis. In all cases except one, there was good concordance betwee n the results of study of androgen receptors and those of the clinical test. Conclusion. - The high-dose androgen test is thus useful in bot h diagnosis and treatment and facilitates the gender assignment.