Pseudovaginal perineoscrotal hypospadias

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Pseudovaginal perineoscrotal hypospadias
Synonyms 46,XY disorder of sex development due to 5-alpha-reductase 2 deficiency
Autosomal recessive - en.svg
Pseudovaginal perineoscrotal hypospadias is inherited in an autosomal recessive manner
Classification and external resources
ICD-10 Q56.1
OMIM 264600
DiseasesDB 11
eMedicine ped/1980
Orphanet 753

Pseudovaginal perineoscrotal hypospadias (PPSH) refers to a configuration of the external genitalia of an infant. In a sense, this configuration is roughly midway between normal male genitalia and normal female genitalia in structure and appearance. It is a relatively common form of genital ambiguity caused by undervirilization of genetic males due to several different intersex conditions.


PPSH usually consists of:

Testes are often palpable in the scrotum or inguinal canals, and the karyotype is XY. In most cases there are no internal female structures such as a uterus or other Müllerian duct derivatives.


It is considered a form of 5-alpha-reductase deficiency involving SRD5A2.[1][2]



When an infant is born with PSH, the most difficult management decision has often been the sex assignment, since genitalia with this degree of ambiguity do not resemble either sex very well with respect to looks or function. Many infants with PPHS have been assigned and raised as female despite presence of testes and XY chromosomes.

Nearly all parents of infants with PPSH are offered surgical reconstruction, to either further masculinize or feminize the external genitalia.

Treatment with testosterone postnatally does not close the urethra or change the malformation, but in some cases may enlarge the penis slightly.

See also[edit]


  1. ^ Bahceci M, Ersay AR, Tuzcu A, Hiort O, Richter-Unruh A, Gokalp D (2005). "A novel missense mutation of 5-alpha reductase type 2 gene (SRD5A2) leads to severe male pseudohermaphroditism in a Turkish family". Urology. 66 (2): 407–10. doi:10.1016/j.urology.2005.02.021. PMID 16098368. 
  2. ^ Eberhard Nieschlag; Hermann M. Behre; Susan Nieschlag (July 2009). Andrology: Male Reproductive Health and Dysfunction. Springer. pp. 328–. ISBN 978-3-540-78354-1. Retrieved 2 January 2011.