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Treatments and drugs
By Mayo Clinic staffManagement of ambiguous genitalia requires a team of doctors that may involve a number of specialties — pediatric endocrinology, neonatology, urology, plastic surgery, medical genetics and psychology. Your medical team can explain to you the options available for your child and likely suggest a course of action. The timing of treatment depends on a child's specific situation.
Treatment options may include:
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Reconstructive surgery. The goal of surgery is usually cosmetic, to make the boy's or girl's genitalia look natural. In some cases, the surgery can be more involved in hopes of restoring sexual function. Results are often satisfying. However, your child may need repeat surgeries later in life. And there is a risk of a disappointing cosmetic result or sexual dysfunction, such as an inability to achieve orgasm.
Certain types of surgery for ambiguous genitalia are most successful when carried out soon after birth, while others are best delayed until later in your child's development — in some cases, until your child reaches sexual maturity. In severe cases of ambiguous genitalia, both the medical and psychological results may be better if surgery is delayed until your child can play a role in participating in the sex-assignment decision.
For girls, sexual function of the organs is often not compromised despite any ambiguous appearance. Depending on the severity of the condition, surgery options range from uncovering a vagina hidden under the skin to removing excess masculine tissue around the clitoris. Surgeries are carried out carefully to avoid damaging nerve endings and blood flow in hopes of ensuring normal sexual function in the future.
For boys, the surgery may be more complicated, but often successful. Surgery gives genetic males born with a shorter, incomplete penis the opportunity to have a more normal penis. In many cases, no further surgery is required for this reconstructed organ, and it will have a normal look and erectile functionality. Female organs that remain under the skin — such as a uterus or vagina — rarely cause a physical problem, but are often surgically removed because a boy's knowledge of these structures later in life may be emotionally difficult.
- Hormone therapy. Depending on the severity of the condition, hormone therapy alone may be enough to correct the initial hormonal imbalance. For example, in a genetic female with a slightly enlarged clitoris caused by a minor to moderate case of congenital adrenal hyperplasia, proper levels of hormones may shrink the tissue close to a normal size.
