Biography
Biography: Benslimane Hammou
Abstract
Introduction: Disorders of Sex Development (DSD) is affecting 1 in 10,000 births. Current management is very heterogeneous because of the low volume of patients for Persistent Mullerian duct syndrome. The persistence syndrome of Mullerian derivatives (PMDS) is a rare form of abnormalities of sex development. The persistence of Mullerian derivatives can be seen as Persistent Mullerian duct syndrome (PMDS): intraoperative diagnosis in case of cure of a hernia in a boy normally virilized with the discovery of a fallopian duct or a uterus when opening the hernia sac during a laparoscopy, the treatment of a nonpalpable testicle. The treatment is surgical and some author recommends dissection to separate the vas mullerian duct , orchidopexy and mullerian duct excision . This treatment is done by laparoscopy and is consist of a longitudinal section of the uterus and the cervix to allow lowering each testicle by an internal pathway within the umbilical artery and preserving the testicular vasculature.
Patients & Methods: Four patients admitted in our department of pediatric urology for Persistent Mullerian duct syndrome from 2015-2017.
After laboratory and radiology work-up ,laparoscopy exploration is indicated in all cases.
Our option is done by laparoscopy and will consist of a longitudinal section of the uterus,and the cervix to allow lowering each testicle in the corresponding hemi-scrotum by a internal pathway within the umbilical artery and preserving the testicular vasculature and the Vas. This is our attitude towards the PMDS syndrome.
Results: One case diagnosis of PMDS either inguinal hernia repair, one case either urethrocystoscopy for utero hydronephrosis bilateral, one non palpable testis in two cases.
Conclusion: Laparoscopy is best way for PMDS diagnosis. Division of Mullerian duct is a safe way to do orchidopexy without damage of the vas.