Gell Jennifer S
Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology, Geisinger Medical Group, Wilkes-Barre, Pennsylvania 18711-3753, USA.
Semin Reprod Med. 2003 Nov;21(4):375-88. doi: 10.1055/s-2004-815593.
The reproductive organs in both males and females consist of gonads, internal ductal structures, and external genitalia. Normal sexual differentiation is dependent on the genetic sex determined by the presence or absence of the Y chromosome at fertilization. Testes develop under the influence of the Y chromosome and ovaries develop when no Y chromosome is present. In the absence of testes and their normal hormonal products, sexual differentiation proceeds along the female pathway, resulting in a normal female phenotype. Anatomic gynecologic anomalies occur when there is failure of normal embryologic ductal development. These anomalies include congenital absence of the vagina as well as defects in lateral and vertical fusion of the Müllerian ducts. Treatment of müllerian anomalies begins with the correct identification of the anomaly and an understanding of the embryologic origin. This includes evaluation for other associated anomalies such as renal or skeletal abnormalities. After correct identification, treatment options include nonsurgical as well as surgical intervention. This chapter serves to review the embryology and development of the reproductive system and to describe common genital tract anomalies. Details of surgical or nonsurgical correction of these anomalies are presented.
男性和女性的生殖器官均由性腺、内部管道结构和外生殖器组成。正常的性分化取决于受精时Y染色体的有无所决定的遗传性别。在Y染色体的影响下睾丸发育，而当不存在Y染色体时卵巢发育。在没有睾丸及其正常激素产物的情况下，性分化沿着女性途径进行，从而产生正常的女性表型。当正常的胚胎管道发育失败时，就会出现解剖学上的妇科异常。这些异常包括先天性无阴道以及苗勒管横向和纵向融合缺陷。苗勒管异常的治疗始于对异常的正确识别以及对胚胎起源的了解。这包括评估其他相关异常，如肾脏或骨骼异常。正确识别后，治疗选择包括非手术以及手术干预。本章旨在回顾生殖系统的胚胎学和发育，并描述常见的生殖道异常。还介绍了这些异常的手术或非手术矫正细节。
