Contrast-Enhanced Voiding Urosonography and Genitography in a Baby with Ambiguous Genitalia and Urogenital Sinus

Introduction

In newborn babies with clinically ambiguous genitalia, a variety of conditions must be considered. The most important ones are congenital adrenal hyperplasia (CAH), genital malformation as part of an overall pattern of malformation, androgen resistance syndrome, pure gonadal dysgenesis or true hermaphroditism (Houk CP et al. UpToDate, Online Publication; 2007: http://www.utdol.com.; Stöllinger O. In: Oswald J et al. Kinderurologie 1999: 136 – 140). When ultrasound (US) findings are not clear, injecting sonographic contrast media through the opening of the urogenital sinus may be helpful for delineating the urogenital sinus and internal duct structures (Kiechl-Kohlendorfer U et al. AJR 2001; 177: 1041 – 1044). This will help to determine the presence of Wolffian versus Müllerian ductal structures (Nguyen HT. In: Baskin LS et al. Handbook of Pediatric Urology 2001: 33 – 49).