The pediatric urology department at Shaare Zedek Medical Center is a national center for reconstructive surgery in children with various endocrine disorders that lead to changes in the external genitalia. These disorders are referred to as Disorders of Sexual Development (DSD), including conditions like Intersex, Hermaphroditism, and Pseudohermaphroditism. As these are endocrine-related conditions, the department's team collaborates with all pediatric endocrinology departments across the country. The department performs various surgeries for bladder construction, different hypospadias repairs, genital reconstruction, orchiectomy (removal of internal genital organs) in boys and girls through a laparoscopic approach, and various diagnostic procedures.
The department's team collaborates with specialized pediatric and adult endocrinologists, as well as psychologists, providing comprehensive support for children with endocrine-related disorders requiring urological-surgical intervention, as well as for their parents. Our department's structure, along with the expertise and experience of our physicians, provide optimal conditions for long-term follow-up for children with diverse disorders requiring surgical correction. Children who have undergone reconstructive urological surgery in our department continue to receive care even after adolescence and throughout their lives, addressing any developing issues.
We work in collaboration with endocrinology and psychology teams to provide comprehensive support for parents of children with endocrine disorders. Parental guidelines can be found on the website of the Accord Alliance, an American organization that supports patients and their families: https://www.accordalliance.org/dsdguidelines/htdocs/parents/index.html
Among the disorders that sometimes require surgical intervention are:
- Congenital adrenal hyperplasia (CAH)
- Atypical development of external genitalia (clitoromegaly or micropenis)
- Complete or partial androgen insensitivity syndrome (AIS)
- 5-alpha-reductase deficiency
- Incomplete development of sex anatomy (vaginal agenesis, gonadal agenesis, or aphallia)
- Sex chromosome anomalies (Turner Syndrome, Klinefelter Syndrome, sex chromosome mosaicism)
- Disorders of gonadal development (ovotestis)
The extensive experience of the Pediatric Urology Department at Shaare Zedek Medical Center in the field of reconstructive surgery for these cases has been published in important journals, positioning the department as a leading entity in this field globally:
https://www.ncbi.nlm.nih.gov/pubmed/16521001
https://www.ncbi.nlm.nih.gov/pubmed/16429100
https://www.ncbi.nlm.nih.gov/pubmed/16148681
https://www.ncbi.nlm.nih.gov/pubmed/14764142
https://www.ncbi.nlm.nih.gov/pubmed/11453519
https://www.ncbi.nlm.nih.gov/pubmed/11371974