Single-stage feminization genitoplasty in girls with congenital adrenal hyperplasia in infancy

Abstract

Introduction. Single-stage feminization genitoplasty under the age of 12 months is recommended by the international consensus on the treatment of girls with congenital adrenal hyperplasia (CAH).The study objective is to evaluate the results of feminization plasty of the external genitals in infancy.Materials and methods. The single-stage feminization genitoplasty results is performed in 11 patients from 6 to 18 months age old with various forms of CAH. The single-stage feminization surgery included clitoroplasty with preservation of the head, dorsal neurovascular bundle, labioplasty and various forms of introitoplasty depending on the level of hypospadias.Results. Recurrence of hypospadias and urethro-vaginal fistula were obtained in 3 (36 %) girls. Given the structural features of the small pelvis in girls at infancy and early age, a good result of single-stage feminization genitoplasty is possible when using an apron-shaped mucous flap with mild and middle hypospadias and urogenital mobilization with severe hypospadias in combination with prolonged glucoand mineralocorticoid compensation of CAH.Conclusion. Indications for single-stage feminization genitoplasty, given the large percentage of complications, should be placed with extreme caution. Surgical intervention is justified in case of recurrent urinary tract infection and dysfunctional urination.The authors declare no conflict of interest.There is given the parental informed consent to the children’s participation in the study.

Keywords

• congenital adrenal hyperplasia
• single-stage feminization surgery
• feminization plasty of the external genitals
• clitorolabiointroitoplasty
• infancy
• female hypospadias