Surgical aspects of ambiguous genitalia associated with congenital adrenal hyperplasia

Abstract

Aim The aim of the study was to review the current approach to manage ambiguous genitalia caused by CAH.
Methods This was a retrospective study of 30 patientswith CAH and ambiguous genitalia treated over 10 years. Age at presentation, degree of verilization,  preoperative diagnostic studies, operative technique, blood loss, outcome, and follow-up period were the studied variables.
Results The older 19 patients underwent single-stage feminizing genitoplasty and the younger 11 patients underwent a  multiple-stage procedure. All patients had undergone clitoroplasty, clitoral recession, or resection. Postoperative  complications documented in 23% of the patients included atrophy of the clitoris, flaps complication, and vaginal stenosis. The anatomic and cosmetic outcomes were considered good or satisfactory in 70% and 20% of cases, respectively, and poor in 10% of cases.
Conclusion One-stage or multiple-stage feminizing genitoplasty gives a high percentage of satisfactory cosmetic outcomes. TUM can be implemented to achieve excellent results for complex genitourinary anomalies.

Keywords: adrenal hyperplasia, congenital, genitoplasty, intersex