Disorders of sexual development

quote from "Pediatric Surgery (Springer Surgery Atlas)" by Prem Puri, Michael E. Höllwarth - "The confluence is not always readily apparent, especially in very masculinized patients who have a UGS resembling a male urethra. In these patients, one must actively look for a verumontanum-like structure with a small “utricular” opening in the proximal urethra. This is the confluence. A guidewire or ureteral catheter should be inserted into this communication through the cystoscope, and then the scope can be passed over the guide into the vagina. In almost all cases, we find it helpful to place a Fogarty catheter into the vagina and inflate the balloon (Fig. 68.1). Even in the …

quote from "Pediatric Surgery (Springer Surgery Atlas)" by Prem Puri, Michael E. Höllwarth - "Rink et al. described the “PVE” classification, in which the length and width of the phallus (P) is measured in centimeters, the location of the vaginal confluence (V) is recorded in centimeters from the bladder neck and from the UGS opening, and the degree of masculinization of the external genitalia (E) is estimated with a Prader number of 1–5."

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Presence of a short proximal urethra is a contraindication for UGS mobilization as this is likely to affect urinary continence

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