Reconstructive urology

Abstract

Editorial CommentIt is well known that the development of the male and female internal and external genitalia is dependent on a complex interaction of specific androgenic and nonandrogenic hormones. In this elegant experimental morphological study, the authors analyzed whether the level of the vaginal confluence with the urogenital sinus moves proximal from perineum to bladder neck as a function of prenatal androgen exposure in a mouse model.The authors found that prenatal exposure to increasing levels of androgen causes a dose dependent change in the confluence of the urogenital sinus and vagina. They observed in this mouse model, a distal elongation of the common urogenital sinus and proximal migration of the bladder neck in respect to the fixed bony structures of the pubic arch. Although the molecular basis of urogenital sinus elongation and migration remains unexplained, the authors speculated that the complex hormonal environment found in patients with congenital adrenal hyperplasia or other abnormalities leading to androgen excess can result in wide spectrum anatomical variations of the vaginal confluence in the urogenital sinus.