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Feminizing reconstructive surgery for ambiguous genitalia: the Leipzig experience.
W Hoepffner1, K Rothe, J Bennek
1Children's Hospital, University of Leipzig, Leipzig, Germany. wolfgang.hoepffner@web.de
The Journal of Urology
|February 14, 2006
Summary
Feminizing reconstructive surgery for ambiguous genitalia, including congenital adrenal hyperplasia (CAH) and micropenis (MPH), shows favorable outcomes. Two-stage procedures are particularly effective for virilized genitalia, enabling sexual function.
Area of Science:
- Endocrinology
- Pediatric Surgery
- Urology
Background:
- Ambiguous genitalia requires specialized surgical and hormonal management.
- Congenital adrenal hyperplasia (CAH) and micropenis (MPH) are common causes of virilized genitalia.
- Long-term functional outcomes, especially sexual function, are crucial for patient well-being.
Purpose of the Study:
- To evaluate the outcomes of feminizing reconstructive surgery for ambiguous genitalia.
- To assess the impact of virilization degree (Prader scale) on surgical results.
- To determine the long-term effects on sexual intercourse capability.
Main Methods:
- A cohort of 58 patients (41 with CAH, 17 with MPH) aged 16-46 years was followed.
- Standardized hormone substitution and reconstructive surgery protocols were applied.
- Patients with more virilized genitalia (Prader IV and V) were treated with a 2-stage surgical approach.
Main Results:
- Revision vaginoplasties were needed in 7 patients (12.1%) due to scar stenosis.
- No patients required neovagina creation.
- Out of 58 patients, 32 achieved sexual intercourse, with 17 having results conducive to intercourse.
Conclusions:
- The two-stage surgical approach yields favorable outcomes for CAH and MPH patients with virilized genitalia (Prader IV and V).
- Feminizing reconstructive surgery can positively impact sexual function in patients with ambiguous genitalia.