Prader described progressive stages in the masculinization of the external female genitalia that may occur in congenital adrenal hyperplasia or other conditions.
Parameters:
(1) clitoromegaly (cliteral hypertrophy)
(2) labial form and fusion
(3) urethral opening
Clitoris
Labia
Urethral Opening
Stage
normal
normal
normal female
0 (normal female)
slight hypertrophy
mild enlargement
normal female
I
mild hypertrophy
moderate enlargement
normal female
II
moderate hypertrophy
enlarged with early fusion and external vaginal stenosis
normal female
III
short phallus
fused
hypospadia (scrotal or penoscrotal)
IV
male-like phallus
fused (scrotum like(
tip of phallus
V (masculinized)
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