My daughter was born with salt wasting CAH in 1997. Her urethra was emptying some urine into her vagina, causing urine to collect in her vagina, since she had no vaginal opening. I am a little confused about the terminology, but I remember her urologist stating that the placement of the vagina was favorable to do an early vaginoplasty. They did not expect many complications from scarring nor any sexual or reproductive problems based on the anatomy of my daughter and doing the early surgery. My daughter was only 6 pounds when she was born, so we had to wait until she weighed enough for our anasthesiologist to feel comfortable putting her under. They also wanted to make sure she was stabilized on her steroids. As far as our decision to do the early surgery, we felt we did not have a choice mainly because with the urine collecting in her vagina, the fluid was building up, putting pressure on her stomach. She would writhe with abdominal pain, and she vomited almost every bit of formula we gave her. We had to catheterize her 6 to 8 times a day, to try to drain the urine. This was not always successful and increased the risk of her getting a UTI. We could not stand to see her in pain and crying all the time, not to mention the barbaric procedure of having to clean and sterilize her with betadine, boil catheters, and perform the procedure until we were able to help relieve the urine. At 2 months old, she was big enough for surgery. They had to separate her labia before making the vaginal opening, so her first surgery was a clitoral reduction and separation of the labia. They also had to create the inner folds of the labia. We were assured that the clitoral reduction was safe, and she would have normal sexual feeling and function. The skin ofher outer labia had started to develop like the scrotum skin, when she is cold, it wrinkles a little and shrinks. However, that has improved much since she has gotten bigger, and once she develops pubic hair, it will be un-noticeable. We had to continue catheterization until 4 months, when they were ready to do the vaginolplasty. It was a suprisingly short surgery, with a very short recovery. She went home within 24 hours, and she was not in much pain at all. It completely solved her problem of not being able to keep food down-she was a different child. She had a catheter that fed into an outer diaper, to keep the urine away from the newly created vagina for 2 weeks I think. We lived in Dallas at the time, and our urologist also did surgery for our son as well. He was great and had experience with CAH patients all around the state-he worked out of 5 hospitals. He was in high demand and did a great job on our daughter, as far as we and other urologists who have seen her are concerned. We spent alot of time at Children's Medical Center in Dallas and Baylor Medical Center in Dallas as well. I can't say they are the best, but we liked our urologist, Dr. David Ewalt. I'm sorry I can't help with some of your other questions. We had to use a dilator for a few weeks, but even still we were almost guaranteed that she would require surgery to stretch the vaginal opening around adolescence. Good Luck and feel free to ask any questions. Nicole Rice