Role of Endoscopy in Diagnosis and Management of DSD

DSD is known to be an incompletely understood condition and as such a lot still needs clarification in terms of gender identity and gender roles for each child. The multiple determinants of sexual identity may change as the child grows into adulthood. So, investigations are needed to establish identity at a stage after birth as well as after puberty. Hence, final management plan with regard to timing, type, and extent of surgery is undergoing a flux at these times. This changing pattern of surgical practice in DSD has cast an additional responsibility on the shoulders of the team to establish a precise diagnosis in DSD as the consequences would affect the child lifelong. In addition to the extensive work-up that is advised for all children, evaluation of internal genitalia requires two most important tools Genitoscopy and Laparoscopy, which have replaced Exploratory Laparotomy for diagnosis. Many therapeutic procedures are also done Laparoscopically and this chapter discusses the various options for the same. Conclusions: Endoscopies have become an essential part of management of DSDs both for diagnostic as well as therapeutic purposes.