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    
Abstract/OtherAbstract:
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.
Authors:
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.
Affiliation:
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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