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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...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2022
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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. |
format | Online Article Text |
id | pubmed-9267529 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
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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