Adult Patients with Aphallia: Were they Fertile?

Abstract

Adult male genotype and phenotype with aphallia are men born without a penis. The effectiveness of male sex assignment or female sex reassignment as a treatment for aphallia has been debated. The study's goal was to address the gonadal existence and supporting investigation related to the reproductive health care of reported cases of aphallia patients such as karyotyping, physical examination, semen analysis, hormone reproduction level, sperm retrieval, radiological investigation type of intervention. In this narrative review, data were obtained from Pubmed and Google Scholar that contains keywords “absence penis", "penile agenesis”, “phalloplasty” “fertility function”. We excluded pediatric patients with aphallia or adult patients with aphallia that reassignments to be female. Only five of the case reports were adult patients with aphallia that reported their fertility function and remains the gonadal existence. All samples have fertility potential disregard their aphallia based on primary testicular function, semen analysis, hormonal profile radiological investigation. Radiology supporting to the investigation of fertility function has aimed to detect genitourinary anomaly related to the site of urinary meatus associated with death rate. Four patients showed post sphincteric meatus urinary and one patient was presphincteric meatus urinary. Gonadal existence is addressed in the case report. This report suggested that sex assignment on aphallia patients should be considered based on the gonadal existence because even though they do not have a penis, they can have children through assisted reproductive technology provided that their phenotype and genotype are matched