Document Detail


Treatment of clitoromegaly of culturally diverse patients.
MedLine Citation:
PMID:  19303817     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Clitoroplasty is a procedure usually performed in young children, but its long-term psychosexual importance is controversial. We present two adult women from different cultural backgrounds who desired surgery for clitoromegaly. METHODS: A similar clitoroplasty procedure with preservation of the neurovascular bundle was performed on both patients. Preoperative and postoperative interviews were conducted by an independent observer to learn about the effects of the condition and the surgery. RESULTS: The Icelandic patient had bilateral ovarian dysgerminomas and a gonadoblastoma. The Bolivian patient had a 17beta-hydroxysteroid oxidoreductase deficiency. Both patients reported normal libido but sexual inactivity because they felt 'embarrassed'. Postoperatively, our patients reported normal clitoral sensation and that they were sexually active. They differed in their opinion regarding the optimal timing of clitoroplasty - one suggesting surgery soon after birth and the other recommending deferral until informed consent by the patient is possible. CONCLUSIONS: Regardless of cultural background patients are affected by clitoromegaly. This is demonstrated in these cases by the reported feelings of discomfort, distress, and sexual inactivity due to embarrassment. The long-term significance of clitoromegaly and the value of clitoroplasty for young patients with disorders of sexual differentiation remain controversial.
Authors:
Hasan S Merali; Patricio C Gargollo; David A Diamond
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Publication Detail:
Type:  Case Reports; Journal Article     Date:  2009-03-21
Journal Detail:
Title:  Journal of pediatric urology     Volume:  5     ISSN:  1873-4898     ISO Abbreviation:  -     Publication Date:  2009 Aug 
Date Detail:
Created Date:  2009-07-14     Completed Date:  2009-10-08     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101233150     Medline TA:  J Pediatr Urol     Country:  England    
Other Details:
Languages:  eng     Pagination:  292-6     Citation Subset:  IM    
Affiliation:
Department of Urology, Children's Hospital Boston, Harvard Medical School, Boston, MA, USA.
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MeSH Terms
Descriptor/Qualifier:
17-Hydroxysteroid Dehydrogenases / deficiency
Adolescent
Adult
Clitoris / abnormalities*,  innervation,  surgery*
Cultural Diversity*
Female
Gonadoblastoma / complications
Gynecologic Surgical Procedures / methods*
Humans
Ovarian Neoplasms / complications
Patient Satisfaction*
Recovery of Function
Sexuality
Chemical
Reg. No./Substance:
EC 1.1.-/17-Hydroxysteroid Dehydrogenases
Comments/Corrections
Comment In:
J Pediatr Urol. 2009 Aug;5(4):297-8; author reply 299   [PMID:  19427814 ]

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


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