Long-Term Assessment of Genital Reconstruction in Female Pseudohermaphrodites

Sotiropoulos, Alexander; Morishima, Akio; Homsy, Yves; Lattimer, John K.

doi:10.1016/s0022-5347(17)59297-6

Cited by 72 publications

(14 citation statements)

References 4 publications

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“…Sotiropoulos et al [9] reviewed 32 females aged between 5 and 22 years and reported cosmetically and functionally satisfactory results after clitoral recession or resection. However, in their experience, vaginoplasty done before puberty required further surgical revision, and they suggested that the vaginoplasty should be deferred until after puberty to produce acceptable outcomes.…”

Section: Discussionmentioning

confidence: 99%

Cosmetic and anatomic outcomes after feminizing surgery for ambiguous genitalia

Lean

Deshpande

Hutson

et al. 2005

Journal of Pediatric Surgery

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Section: Discussionmentioning

confidence: 99%

Cosmetic and anatomic outcomes after feminizing surgery for ambiguous genitalia

Lean

Deshpande

Hutson

et al. 2005

Journal of Pediatric Surgery

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“…[17] The majority of series in the literature describing follow-up after early vaginoplasty report high re-operation rates at or after puberty. [9131418–23] We freely acknowledge this to the families of our patients. However, many of these same authors recommend early vaginoplasty, as the revisional surgery needed around puberty is usually relatively minor, with excellent long-term results.…”

Section: Discussionmentioning

confidence: 99%

Feminizing genital reconstruction in congenital adrenal hyperplasia

Leslie¹,

Cain²,

Rink³

2009

Indian J Urol

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The past several decades have seen multiple advances in the surgical reconstruction for girls born with Disorders of Sexual Differentiation. This surgery can be technically very demanding, and must be individualized for each patient, as the degree of virilization and level of confluence of the vagina and urogenital sinus will dictate the surgical approach.In this manuscript we present our approach and experience in the surgical options for girls born with Congenital Adrenal Hyperplasia, with special attention regarding clitoroplasty, urogenital mobilization, and vaginoplasty.

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“…Os partidários da realização da genitoplastia precoce (logo após o nascimento) em um estágio argumentam que a estimulação estrogênica materna promove uma vagina larga, vascularizada e mais superficial, com paredes mais grossas e de fácil manipulação (14,20). Por outro lado, diversos autores questionam a necessidade da correção precoce, com base no alto índice de complicações e na necessidade de cirurgias corretivas múltiplas (7,(21)(22)(23).…”

Section: Discussionunclassified

Genitoplastia feminizante e hiperplasia congênita das adrenais: análise dos resultados anatômicos

Miranda

Filho

Lemos-Marini

et al. 2005

Arq Bras Endocrinol Metab

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RESUMOObjetivo: Avaliar os resultados anatômicos e cosméticos das genitoplastias feminizantes realizadas em meninas com genitália ambígua devido à Hiperplasia Congênita das Adrenais (HCA). Casuística e Métodos: Vinte e sete meninas com HCA e ambigüidade genital (Prader III-V) foram submetidas a genitoplastia feminizante em um estágio e acompanhadas por período médio de quatro anos. Em doze meninas, dois retalhos labioescrotais em ilha foram associados à genitoplastia convencional para adequar os grandes lábios e ampliar o intróito vaginal. Episódios de infecção urinária foram observados em dezesseis meninas no pré-operatório e em apenas sete no pós-operatório. Os resultados cosméticos foram avaliados por meio de sistematização da avaliação anatômica das diferentes estruturas. Resultados: Os da clitoroplastia foram considerados bons em 62,9% dos casos; houve atrofia clitoriana em quatro meninas. Excesso de grandes lábios ocorreu em 25%, e persistência do seio-urogenital em 11% (três meninas nas quais não havia sido associado retalho labioescrotal). O retalho labioescrotal em ilha foi considerado de simples confecção e reprodução. Cinco meninas precisaram ser re-operadas. De um modo geral, os resultados cosméticos foram considerados ótimos ou bons em 63% dos casos, satisfatórios em 18,5% e insatisfatórios ou ruins em 18,5%. Conclusões: Os resultados anatômicos e cosméticos foram classificados como bons na maioria dos casos, porém alguns aspectos técnicos devem ser ajustados com a intenção de evitar complicações irreversíveis e re-operações. Objective: To evaluate the anatomical and cosmetic results of feminizing genitoplasty in girls with ambiguous genitalia due to Congenital Adrenal Hyperplasia (CAH). Casuistic and Methods: Twenty-seven females with genital ambiguity (Prader III-V) due to CAH underwent an one-stage feminizing genitoplasty and were followed for a mean time of 4 years. In twelve girls, two cutaneous labioscrotal island-flaps were associated with the conventional genitoplasty, to decrease the excess of labia majora and to enlarge the vaginal introitus. Urinary tract infections were observed in sixteen girls in the preoperative and in only seven in the postoperative period. The cosmetic results were obtained by the systematic anatomical evaluation of the different structures that compose the genitalia. Results: The results of clitoroplasty were considered good in 63% of the cases; however, 4 girls developed clitoral atrophy. An excess of labia majora was present in 25% and persistence of the urogenital sinus occurred in 11% (three children without labioscrotal island flap). The labioscrotal island flap was considered technically feasible and reproducible. Five girls had to be re-operated. The cosmetic results were considered excellent or good in 63% of the cases, satisfactory in 18.5% and unsatisfactory or bad in 18.5%. Conclusions: The anatomical and cosmetic results were good in majority of the cases; however, some technical aspects should be adjusted, to avoid irreversible sequels and re-operation...

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Long-Term Assessment of Genital Reconstruction in Female Pseudohermaphrodites

Cited by 72 publications

References 4 publications

Cosmetic and anatomic outcomes after feminizing surgery for ambiguous genitalia

Cosmetic and anatomic outcomes after feminizing surgery for ambiguous genitalia

Feminizing genital reconstruction in congenital adrenal hyperplasia

Genitoplastia feminizante e hiperplasia congênita das adrenais: análise dos resultados anatômicos

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