Short-term outcomes of interventions for reproductive dysfunction

描述(由申请人提供)：是否通过手术矫正模糊的生殖器，使其在生殖器成形术中更具女性或男性特征，这是儿科医学中一个极具争议的领域。手术后美容不良和过时手术后的性功能障碍等次优结果在医学界引发了激烈的争论，争论的焦点是生殖器成形术应该如何或是否应该用于治疗生殖器不清的幼儿。为了解决这一争论，需要对在童年早期接受男性化或女性化手术的个体进行一项前瞻性研究，研究当前生殖器成形术的结果，包括与这些手术相关的并发症发生率。此外，对决定是否继续为年幼的孩子进行生殖器成形术的父母进行研究，对于了解这些有争议的决定如何影响父母对孩子手术结果的反应是必要的。这项建议的总体目标是评估现代生殖器成形术技术的结果，同时考虑做出决定继续为孩子进行生殖器手术的父母的心理结果。这一信息至关重要。 医生向父母提供指导，说明处理幼儿生殖器不明确的最佳方法，包括没有手术是最好的可能性。拟议研究中包括的临床医生和研究人员的跨学科小组横跨心理学、统计学、儿科内分泌学和儿科泌尿学领域。 我们团队的集体经验优化了我们及时将拟议研究的结果转化为临床环境的能力。

DESCRIPTION (provided by applicant): Whether or not to surgically correct ambiguous genitalia to be more female- or male-typical with genitoplasty is an area of pediatric medicine that is highly controversial. Suboptimal outcomes such as poor post-surgical cosmesis and sexual dysfunction following outdated surgical procedures have driven intense controversy in the medical community over how, or if, genitoplasty should be used in the treatment of young children with ambiguous genitalia. To resolve this debate, a prospective study of outcomes of current genitoplasty procedures, including complication rates associated with these procedures, is needed of individuals who receive masculinizing or feminizing surgery during early childhood. Additionally, studies of parents who decide to proceed, or not, with genitoplasty for their young child are necessary to understand how these controversial decisions impact parents' reactions to surgical outcomes for their child. The overall goal of this proposal is to assess the outcomes of modern genitoplasty techniques with a consideration of the psychological outcome of parents who make the decisions to proceed with genital surgery for their child. This information is crucial for physicians to provide guidance to parents regarding the optimal approach for the management of ambiguous genitalia in young children, including the possibility that no surgery is best. The interdisciplinary group of clinicians and researchers included in the proposed studies spans the fields of psychology, statistics, pediatric endocrinology, and pediatric urology. The collective experience of our group optimizes our ability to translate findings from the proposed studies to a clinical setting in a timely manner.