Introitoplasty and vulvaplasty in abnormality of external genitalia in gils with congenital adrenal hyperplasia

M.P. Batygin, A.K. Fayzulin, T.M. Glybina

Chair of Pediatric Surgery of Moscow State Medical and Dental University
Izmailov Children’s Hospital, Moscow, Russia

In order to improve the methods of surgical correction of the external genitalia in girls authors have analyzed the results of treatment 87 patients with congenital adrenal hyperplasia (CAH).

For the first group of patients (n=60) was performed surgical correction of defect by standard introitoplasty with M-shaped skin flap without separating the genital and urinary tract that leading to a large number of complications in adult life in the form of recurrent urinary tract infections (94%); in the second group (n = 16) - performed introitoplasty with separating urinary and genital tract with preservation of fragments of the urogenital sinus as artificial urethra; with the third group (n=11) of patients with milder forms of CAH - introitoplasty in combination with urethroplasty by Thiersch - Dyuplei principle.

In the postoperative period in one girl of the second group urethra - vaginal fistula is formed, which is itself closed for one month. A third group - complications were not found.

The presence of abnormality of congenital external genitalia in girls with CAH, accompanied by a narrowing of the vestibule of vagina and hypospadias is an indication for introitoplasty and the creation of artificial urethra for separation genital and urinary tract and prevention infections of urinary and genital tract.

Keywords: urogenital sinus, congenital adrenal hyperplasia, introitoplasty, urethroplasty, surgical correction of external genitalia.

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