Assessment of Intersex
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Intersex Surgery: Cloacal Exstrophy and Bladder Exstrophy Repairs

These kinds of surgery repair are required regardless of the sex of rearing or assignment.

Cloacal exstrophy in a genetic female generally involves major surgical reconstruction of the entire perineum, including the bladder, clitoris, symphysis pubis, and both the vaginal introitus and urethra. At most time the urethra and ovaries are usually normal formed.

Simple bladder exstrophy in a genetic female usually does not involve the vagina.

Both severe cloacal and bladder exstrophy in genetic males often causes the phallus widely split, small, and unsalvageable. The scrotum is also widely split too. The testes themselves usually are normal.


Potential Problems

Surgery for severe degrees of cloacal exstrophy is usually extensive and it carried out at multistage.

There can be a variety of complications and problems including:

  • Long-term colostomy or vesicostomy.
  • Creating a functional urethra is difficult. Healing will also be poor with scarring, stricture or fistula and can also require a vesicostomy to prevent urinary incontinence.
  • Construction of a functional anal sphincter is difficult especially when it has been disrupted.
Surgeons also face the added challenge of most severely affected genetic females, and for genetic males who have been raised as females. Surgeons are required to construct a neovagina. Scarring can then be extensive and at time the lower torso will become disfigured even with the best outcomes.


For other feminizing intersex surgery:

Clitorectomy : Clitoroplasty : Clitoral recession
Clitoral reduction : Vaginoplasty : Gonadectomy


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