Fetal genital anatomy reconstructive implications

Purpose: Genital anomalies are not typically diagnosed and/or treated in ut ero. Recent reports have focused on the prenatal treatment of congenital ad renal hyperplasia. The normal male and female genitalia anatomy is reviewed with an emphasis on reconstructive implications. Materials and Methods: Normal fetal genital anatomy was analyzed by serial immunohistochemical staining and 3-dimensional computer reconstruction. Results: The neuroanatomy was analogous in male and female patients, reveal ing an extensive network of nerves not only at the 11 and 1 o'clock positio n, but completely surrounding the ventral aspect of erectile bodies. The 12 o'clock position was notable for a lack of nerves which has implications i n the design of penile straightening procedures. Ultrastructure of the fema le corporeal bodies is similar to the male counterpart. Evaluation of a fet al specimen with hypospadias revealed a similar anatomy to the normal penis except at the area of deficient urethral spongiosum. Conclusions: Attention to anatomical detail will improve surgical technique s for reconstruction in patients with penile curvature and masculinization of the external genitalia.