Genitoplastia feminizante em meninas portadoras de hiperplasia congenita das supra-renais : aspectos tecnicos e analise dos resultados anatomicos

AUTOR(ES)

Marcio Lopes Miranda

DATA DE PUBLICAÇÃO

2003

RESUMO

The aim of this study was to evaluate the anatomical and cosmetic results of the feminizing genitoplasty in girls with ambiguous genitalia. METHODOLOGY: The present series consists of twenty-seven females with genital ambiguity (Prader III?V), due to HCSR, who underwent one stage feminizing genitoplasty and were followed for a median time of four years. In twelve girls, two cutaneous labioscrotal island-flaps were associated with the conventional genitoplasty, to decrease the excess of labia majora and to enlarge the vaginal introitus. Urinary tract infection was confirmed in sixteen (59,2%) girls in the preoperative and in only seven (25,9%) in the postoperative period. The cosmetic results were obtained by the systematic anatomical evaluation of the different structures that compose the genitalia. RESULTS: The results of the clitoroplasty were considered good in 63% of the cases, however, four girls developed clitoral atrophy. The excess of labia majora was present in a 25% and persistence of the urogenital sinus occurred in eleven percent. Among children in whom the labioscrotal island flap wasn?t performed, urogenital sinus was observed in three girls. Overall five girls had to be re-operated. The cosmetic results were considered excellent or good in 62,9%, satisfactory in 18,5% and unsatisfactory or bad in 18,5%. CONCLUSIONS: The anatomical and cosmetic results were good in majority of cases, nevertheless some technical aspects should be adjusted, to eliminate irreversible sequels and avoid re-operations. The postoperative reduction of urinary tract infection incidence suggests that correction of the urogenital sinus was associated with urinary tract decontamination. The Labioscrotal island flap was considered technically feasible and reproducible, presented excellent viability and maintained the urethra separate from vagina in all cases where it was used

ASSUNTO(S)

aparelho genitourinario - cirurgia retalhos cirugicos glandulas supra-renais aparelho genital - anomalias e deformidades hiperplasia disturbios sexuais

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