Perioperative Characteristics and Postoperative Complications of Pediatric Clitoral Reconstruction

Abstract

Pediatric clitoral reconstruction is performed in cases of hypertrophy to return clitoral form and function. The optimal timing and type of surgical reconstruction procedure in children with Disorders of Sex Development are highly debated. There are no previous nationwide cohort studies of pediatric clitoral reconstruction. We aim to describe the perioperative characteristics and postoperative outcomes of patients that underwent pediatric clitoral reconstruction in the United States. A retrospective cohort analysis was conducted using the National Surgical Quality Improvement Program Pediatric (NSQIP-P) database from 2012 to 2020. All patients who underwent clitoral reconstruction using the CPT code 56805 were analyzed. 111 female patients underwent clitoral reconstruction. The median patient age was 2.7 years (IQR 1.0–7.3). The mean (SD) length of total hospital stay was 1.9 days (1.7), and the total operation time was 210.9 minutes (112.3). The most common diagnosis at the time of surgery was congenital adrenal hyperplasia (48.6%). The complication rate was 0.9% and was due to bleeding/transfusions. The readmission rate was 5.6%. Overall, pediatric clitoral reconstruction is a safe procedure with low 30-day post-operative complication rates and an acceptable perioperative course. Further research into postoperative complications is essential to inform decision-making regarding the operative management approach.