Gonadal morphology in cloacal exstrophy: Implications in gender assignment

R. I. Mathews, E. Perlman, D. W. Marsh, J. P. Gearhart*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

28 Scopus citations


Objective: To compare the histology of gonads excised from males with cloacal exstrophy (the most severe variant of the exstrophy-epispadias complex) undergoing early gonadectomy and gender reassignment (to obviate difficulties in reconstructing male external genitalia) with those published previously. Patients and methods: Testicular tissue was obtained from males with cloacal exstrophy undergoing gender reassignment shortly after birth. Slides were stained for histological evaluation and reviewed by one author. The histology was compared with known normal features for newborn testicular tissue. The mean age at the time of gender reassignment was 6 months. Results: There were no significant abnormalities in the architecture of the rete testis, epididymis or vas of the study specimens. There were more germ cells in some patients with cloacal exstrophy, but this finding was not specific and is of unknown clinical significance. Conclusions: Despite the severity of the malformations in cloacal exstrophy, testicular histology is preserved. In highly selected genotypic males who have adequate phallic structures, congruent gender assignment is appropriate and early orchidopexy is recommended.

Original languageEnglish (US)
Pages (from-to)99-100
Number of pages2
JournalBJU International
Issue number1
StatePublished - 1999


  • Cloacal exstrophy
  • Gender assignment
  • Histology
  • Testis

ASJC Scopus subject areas

  • Urology


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