Does common channel length affect surgical choice in female congenital adrenal hyperplasia patients?

Abstract Objective Partial/total urogenital sinus mobilization (UGSM) is one of the recommended techniques for treatment of female congenital adrenal hyperplasia (CAH). In this study we compared the length of common channel (CC) and type of operation performed in CAH patients. Patients and methods W...

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Published in:Journal of pediatric urology 2014-10, Vol.10 (5), p.948-954
Main Authors: Tugtepe, Halil, Thomas, David Terence, Turan, Serap, Cizmecioglu, Filiz, Hatun, Sukru, Bereket, Abdullah, Dagli, E. Tolga
Format: Article
Language:English
Subjects:
Adrenal Hyperplasia, Congenital - pathology
Adrenal Hyperplasia, Congenital - surgery
Child, Preschool
Clitoris - surgery
Cloaca - pathology
Cloaca - surgery
Common channel
Congenital adrenal hyperplasia
Cystoscopy
Female
Humans
Infant
Pediatrics
Retrospective Studies
Suture Techniques
Urethra - surgery
Urogenital sinus mobilization
Urology
Vagina - surgery
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Summary:Abstract Objective Partial/total urogenital sinus mobilization (UGSM) is one of the recommended techniques for treatment of female congenital adrenal hyperplasia (CAH). In this study we compared the length of common channel (CC) and type of operation performed in CAH patients. Patients and methods We retrospectively analyzed data of patients receiving surgery for female CAH. Patients were separated into three groups: group 1 had partial UGSM, group 2 had total UGSM, and group 3 had total UGSM plus the vaginal anterior wall was made from CC. Age at surgery, length of CC, surgical time, follow-up time, and complications were compared. Results There were a total of 29 patients. For groups 1, 2, and 3, the average age at surgery was 47.2 months, 14.4 months, and 21.3 months, respectively, and the average CC length was 1.25 cm, 3.1 cm, 4.3 cm, respectively. The average time of surgery was 165 min, 193.1 min, 282.5 min, respectively. The average follow-up time was 34.7 months, 36.3 months, 28.3 months, respectively. There were two complications (UGS flap necrosis and opening of sutures) in the third group. Conclusion We advise the use of partial UGSM for CC of 0.5–2 cm, total UGSM for CC of 2.5–3.5 cm, and total USM with use of CC as the anterior vaginal wall in CC ≥ 4 cm in length. Good cosmetic and functional results are obtained with this approach.
ISSN:1477-5131
1873-4898
DOI:10.1016/j.jpurol.2014.02.012