腔镜在两性畸形诊治中的应用(附33例报告)

Application of Endoscopy in the Diagnosis and Treatment of Hermaphroditism: Report of 33 Cases

目的：探讨腔镜在两性畸形诊治中的作用及优势。方法2007年1月～2015年5月采用腔镜技术对33例两性畸形进行探查，性腺活检，切除与选择性别不符的性腺（或因扭转坏死的睾丸）、内生殖管道，行阴道成形术或睾丸下降固定术。结果33例通过腔镜诊断或治疗，其中29例行尿道膀胱镜检查，2例宫腔镜手术，6例腹腔镜手术。最终社会性别10例为男性，23例为女性。术后并发症3例：1例尿漏，1例阴囊皮下渗血，1例为外阴切口水肿、渗血。结论尿道膀胱镜、宫腔镜及腹腔镜均可适用于两性畸形的诊治，可明确患者生殖泌尿道发育情况及性腺性质，并行必要的手术治疗。

Objective To investigate the role and advantage of endoscope in the diagnosis and treatment of hermaphroditism . Methods From January 2007 to May 2015, a total of 33 cases of hermaphroditism were examined with endoscopy and gonadal biopsy . The internal tract and the non-selected gonad or necrotic twisted testicle were cut off .Cryptorchidopexy or vaginoplasty was given under endoscope. Results Endoscopic diagnosis and treatment was carried out in all the 33 cases.There were 29 patients receiving urethroscopic examination , 2 patients receiving uteroscopic surgery and 6 patients diagnosed or treated by laparoscope .Finally 10 patients chose socially male and 23 socially female .There were 3 cases of postoperative complications , including 1 case of urinary fistula, 1 case of subcutaneous hermorrhage of scrotum and 1 case of edematous incision and infiltrating blood . Conclusion Urethroscope , uteroscope and laparoscope can be used in the diagnosis and treatment of hermaphroditism .The developmental condition of urogenital canal and the types of gonad can be defined by endoscopy , followed by further surgical treatment .