One stage feminizing genitoplasty: 4 years of experience with 29 cases
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Date
2008-11-16
Authors
Dr. Jehad M. Abu Daia
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Abstract
<p>Purpose: We retrospectively evaluated the results of one-stag feminizing genitoplasty in children with congenital adrenal hyperplasia (CAH).</p>
<p>Patients And Methods: Twenty nine patients with 46XX CVAH (congenital verilized adrenal hyperplasia )patients were referred following complete evaluation of gender, chromosomal and biochemical data by pediatric endocrinologists in 6 year period between 2001 and 2007- at European Gaza Hospitan –Gaza ; 28 patient( new cases 26 + Redo 2)were managed by one-stage feminizing genitoplasty (vaginoplasty-valvoplasty and clitroplasty ),age 3monthes to 12 years.We used the Passerini-Glazel technique, and in 5 patients we mobilize the urogenital sinus en bloc , one female patient underwent gender reversal and was raised as males.</p>
<p>Results: Follow up was 3 monthsto 6 years. Preoperative ultrasound plus or minus genitogram<br />
and endoscopy provide the correct data regarding the vaginal and internal genital anatomy in all cases, Operating time ranged between 90 and 180 minutes, average hospitalization period was 4 to 9 days Complications consisted of intraoperative uretheral injury in 1 case wound infection in 2 and stenosis at the suture line in 2 patients -corrected by introitoplasty . All patients have had successful cosmetic results except one need redo clitroplasty for residual clitoromegalia.</p>
<p>Conclusion: Most patients with 46XX CVAH are preferably raised as females and require a feminizing genitoplasty . Preoperative investigations and surgical managment of every case on its own merits gives satisfactory primary results , some revision at puberty should be anticipated in some cases.</p>
<p>Purpose: We retrospectively evaluated the results of one-stag feminizing genitoplasty in children with congenital adrenal hyperplasia (CAH).</p> <p>Patients And Methods: Twenty nine patients with 46XX CVAH (congenital verilized adrenal hyperplasia )patients were referred following complete evaluation of gender, chromosomal and biochemical data by pediatric endocrinologists in 6 year period between 2001 and 2007- at European Gaza Hospitan –Gaza ; 28 patient( new cases 26 + Redo 2)were managed by one-stage feminizing genitoplasty (vaginoplasty-valvoplasty and clitroplasty ),age 3monthes to 12 years.We used the Passerini-Glazel technique, and in 5 patients we mobilize the urogenital sinus en bloc , one female patient underwent gender reversal and was raised as males.</p> <p>Results: Follow up was 3 monthsto 6 years. Preoperative ultrasound plus or minus genitogram<br /> and endoscopy provide the correct data regarding the vaginal and internal genital anatomy in all cases, Operating time ranged between 90 and 180 minutes, average hospitalization period was 4 to 9 days Complications consisted of intraoperative uretheral injury in 1 case wound infection in 2 and stenosis at the suture line in 2 patients -corrected by introitoplasty . All patients have had successful cosmetic results except one need redo clitroplasty for residual clitoromegalia.</p> <p>Conclusion: Most patients with 46XX CVAH are preferably raised as females and require a feminizing genitoplasty . Preoperative investigations and surgical managment of every case on its own merits gives satisfactory primary results , some revision at puberty should be anticipated in some cases.</p>
<p>Purpose: We retrospectively evaluated the results of one-stag feminizing genitoplasty in children with congenital adrenal hyperplasia (CAH).</p> <p>Patients And Methods: Twenty nine patients with 46XX CVAH (congenital verilized adrenal hyperplasia )patients were referred following complete evaluation of gender, chromosomal and biochemical data by pediatric endocrinologists in 6 year period between 2001 and 2007- at European Gaza Hospitan –Gaza ; 28 patient( new cases 26 + Redo 2)were managed by one-stage feminizing genitoplasty (vaginoplasty-valvoplasty and clitroplasty ),age 3monthes to 12 years.We used the Passerini-Glazel technique, and in 5 patients we mobilize the urogenital sinus en bloc , one female patient underwent gender reversal and was raised as males.</p> <p>Results: Follow up was 3 monthsto 6 years. Preoperative ultrasound plus or minus genitogram<br /> and endoscopy provide the correct data regarding the vaginal and internal genital anatomy in all cases, Operating time ranged between 90 and 180 minutes, average hospitalization period was 4 to 9 days Complications consisted of intraoperative uretheral injury in 1 case wound infection in 2 and stenosis at the suture line in 2 patients -corrected by introitoplasty . All patients have had successful cosmetic results except one need redo clitroplasty for residual clitoromegalia.</p> <p>Conclusion: Most patients with 46XX CVAH are preferably raised as females and require a feminizing genitoplasty . Preoperative investigations and surgical managment of every case on its own merits gives satisfactory primary results , some revision at puberty should be anticipated in some cases.</p>