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Techniques of Primary Vaginoplasty in Young Adults with Differences of Sex Development and Female Identification

Background: The ideal timing of genital surgery in differences/disorders of sex development (DSD) is controversial and differs according to the underlying type of DSD. Increasing numbers of persisting sinus as a result of delayed feminizing genitoplasty in DSD patients require interdisciplinary coll...

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Autores principales: Ellerkamp, Verena, Rall, Kristin Katharina, Schaefer, Juergen, Brucker, Sara, Fuchs, Joerg
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9267529/
https://www.ncbi.nlm.nih.gov/pubmed/35806974
http://dx.doi.org/10.3390/jcm11133688
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author Ellerkamp, Verena
Rall, Kristin Katharina
Schaefer, Juergen
Brucker, Sara
Fuchs, Joerg
author_facet Ellerkamp, Verena
Rall, Kristin Katharina
Schaefer, Juergen
Brucker, Sara
Fuchs, Joerg
author_sort Ellerkamp, Verena
collection PubMed
description Background: The ideal timing of genital surgery in differences/disorders of sex development (DSD) is controversial and differs according to the underlying type of DSD. Increasing numbers of persisting sinus as a result of delayed feminizing genitoplasty in DSD patients require interdisciplinary collaboration of pediatric surgeons/urologists and gynecologists. This study focusses on surgical techniques other than bowel vaginoplasties and results of gender assigning surgery in young adolescents. Methods: Data of adolescent and adult patients treated between 2015 and 2022 were analyzed retrospectively: underlying type of malformation, techniques of vaginoplasty, vaginal length and caliber, possibility of sexual intercourse, and temporary vaginal dilatation. Results: A total of 9 patients received a primary vaginoplasty at a median age of 16.75 years (range 10.3–29.25). The underlying anatomical conditions were persistent urogenital sinus (UGS) in 8 patients (3 patients with CAH, 2 patients with XY-DSD, 1 patient with cloacal malformation and missed UGS, 2 patients with UGS only). One patient had a MURCS association. Surgical techniques were total urogenital mobilization and perineal flap vaginoplasty in 4 patients, modified McIndoe vaginoplasty in 4 patients, and a laparoscopic vaginal pull-through in 1 patient. In a median follow-up of 45 months (2–84), all but 1 patient presented with physiological vaginal length and width. Conclusions: If possible, modern treatment concepts delay gender assigning surgery until the participation of the patient in the decision-making process is possible. Optimal treatment concepts are given by transfer of surgical techniques from pediatric urology/surgery by multidisciplinary teams. Techniques other than bowel vaginoplasties are favorable.
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spelling pubmed-92675292022-07-09 Techniques of Primary Vaginoplasty in Young Adults with Differences of Sex Development and Female Identification Ellerkamp, Verena Rall, Kristin Katharina Schaefer, Juergen Brucker, Sara Fuchs, Joerg J Clin Med Article Background: The ideal timing of genital surgery in differences/disorders of sex development (DSD) is controversial and differs according to the underlying type of DSD. Increasing numbers of persisting sinus as a result of delayed feminizing genitoplasty in DSD patients require interdisciplinary collaboration of pediatric surgeons/urologists and gynecologists. This study focusses on surgical techniques other than bowel vaginoplasties and results of gender assigning surgery in young adolescents. Methods: Data of adolescent and adult patients treated between 2015 and 2022 were analyzed retrospectively: underlying type of malformation, techniques of vaginoplasty, vaginal length and caliber, possibility of sexual intercourse, and temporary vaginal dilatation. Results: A total of 9 patients received a primary vaginoplasty at a median age of 16.75 years (range 10.3–29.25). The underlying anatomical conditions were persistent urogenital sinus (UGS) in 8 patients (3 patients with CAH, 2 patients with XY-DSD, 1 patient with cloacal malformation and missed UGS, 2 patients with UGS only). One patient had a MURCS association. Surgical techniques were total urogenital mobilization and perineal flap vaginoplasty in 4 patients, modified McIndoe vaginoplasty in 4 patients, and a laparoscopic vaginal pull-through in 1 patient. In a median follow-up of 45 months (2–84), all but 1 patient presented with physiological vaginal length and width. Conclusions: If possible, modern treatment concepts delay gender assigning surgery until the participation of the patient in the decision-making process is possible. Optimal treatment concepts are given by transfer of surgical techniques from pediatric urology/surgery by multidisciplinary teams. Techniques other than bowel vaginoplasties are favorable. MDPI 2022-06-27 /pmc/articles/PMC9267529/ /pubmed/35806974 http://dx.doi.org/10.3390/jcm11133688 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Ellerkamp, Verena
Rall, Kristin Katharina
Schaefer, Juergen
Brucker, Sara
Fuchs, Joerg
Techniques of Primary Vaginoplasty in Young Adults with Differences of Sex Development and Female Identification
title Techniques of Primary Vaginoplasty in Young Adults with Differences of Sex Development and Female Identification
title_full Techniques of Primary Vaginoplasty in Young Adults with Differences of Sex Development and Female Identification
title_fullStr Techniques of Primary Vaginoplasty in Young Adults with Differences of Sex Development and Female Identification
title_full_unstemmed Techniques of Primary Vaginoplasty in Young Adults with Differences of Sex Development and Female Identification
title_short Techniques of Primary Vaginoplasty in Young Adults with Differences of Sex Development and Female Identification
title_sort techniques of primary vaginoplasty in young adults with differences of sex development and female identification
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9267529/
https://www.ncbi.nlm.nih.gov/pubmed/35806974
http://dx.doi.org/10.3390/jcm11133688
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