Document Detail

Secondary vaginoplasty for disorders for sexual differentiation: Is there a right time? Challenges with compliance and follow-up at a multidisciplinary center.
MedLine Citation:
PMID:  22884689     Owner:  NLM     Status:  Publisher    
PURPOSE: We present the experience of a multidisciplinary center for disorders of sexual differentiation (DSD) in treating females requiring vaginoplasty. Specifically, we evaluate outcomes and compliance with follow-up protocols in patients undergoing secondary vaginoplasties. MATERIALS/METHODS: We retrospectively reviewed consecutive DSD patients who underwent feminizing genitoplasties in 2006-2010. A subset of patients were instructed in vaginal self-dilation at time of secondary vaginoplasty. Through follow-up visits and administered questionnaires we assessed outcomes, compliance and overall satisfaction. RESULTS: Twenty-two feminizing genitoplasties were completed during the study interval. There were no postoperative complications; average blood loss was 74 ml and mean length of stay was 3 days. Ten females underwent secondary vaginoplasty. The response rate to questionnaires was 5 of 9. Age of initiation for self-dilation ranged from 8 to 24 years. Initial compliance two months postoperatively was good, but diminished 12-24 months after surgery. Responses to the quality-of-life questionnaire were diverse, reflecting a range of patient ages and varied experiences. CONCLUSION: A multidisciplinary, comprehensive approach is necessary to care for patients with DSD due to psychosexual, medical and reconstructive concerns. A secondary vaginoplasty to facilitate menarche and psychosocial concerns is feasible with minimal complications, though compliance and toleration with regard to post-surgical dilation regimens is variable.
Katie H Willihnganz-Lawson; Sumit Isharwal; Jane M Lewis; Kyriakie Sarafoglou; Anne Boisclair-Fahey; Aseem R Shukla
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-8-8
Journal Detail:
Title:  Journal of pediatric urology     Volume:  -     ISSN:  1873-4898     ISO Abbreviation:  J Pediatr Urol     Publication Date:  2012 Aug 
Date Detail:
Created Date:  2012-8-13     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101233150     Medline TA:  J Pediatr Urol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2012 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.
Pediatric Urology, Department of Urology, University of Minnesota, Amplatz Children's Hospital, 420 Delaware Street, SE, MMC 394, Minneapolis, MN 55455, USA.
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