Document Detail

Congenital adrenal hyperplasia: preliminary observations of the urethra in 9 cases.
MedLine Citation:
PMID:  11743338     Owner:  NLM     Status:  MEDLINE    
PURPOSE: Congenital adrenal hyperplasia is the most common cause of androgen mediated virilization of the genitourinary tract in females. In our study relative lengths of the internal genital duct structure were compared with the degree of virilization of the external genitalia. MATERIALS AND METHODS: The records of 9 consecutive female patients with a median age of 2.6 years with congenital adrenal hyperplasia were studied. There were 4 normal females with a median age of 7.4 months who had a voiding cystourethrogram for urinary tract infection used as controls. The patients with congenital adrenal hyperplasia were stratified into groups as having mild, moderate or severe virilization based on preoperative photographs of external genitalia. By lateral voiding cystourethrograms the length of the proximal urethra, vagina and urogenital sinus was measured and standardized against the femoral metaphysis. The relative length of these internal genital structures was compared to the degree of virilization of the external genitalia. RESULTS: There were 4 cases classified as normal, and 2 mildly, 4 moderately and 3 severely virilized. The urogenital sinus appeared to lengthen, with increasing virilization of the external genitalia. There was no trend for the proximal urethra to shorten with increasing virilization. The vagina also seemed to shorten with increasing virilization. CONCLUSIONS: Our results suggest that the vagina enters the urogenital sinus at a fixed distance from the bladder neck. With increasing virilization, the majority of urethral lengthening occurs primarily distal to the vaginal opening, that is urogenital sinus lengthening.
A Ganesan; G H H Smith; K Broome; A Steinberg
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Journal of urology     Volume:  167     ISSN:  0022-5347     ISO Abbreviation:  J. Urol.     Publication Date:  2002 Jan 
Date Detail:
Created Date:  2001-12-14     Completed Date:  2002-01-17     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0376374     Medline TA:  J Urol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  275-8; discussion 278-9     Citation Subset:  AIM; IM    
Department of Paediatric Urology, The Children's Hospital at Westmead, Westmead, Australia.
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MeSH Terms
Adrenal Hyperplasia, Congenital / pathology*
Child, Preschool
Urethra / pathology*
Virilism / pathology

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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