Jenny I don't know if the 1981 technique is the same one that the 1992 and 2000 papers referred to.  The point is that if using dilation after vaginoplasty was tried in a 1981 procedure it indicates that post surgical dilation is nothing new.   The fact that a follow up study done in August of 2000 is still reporting a high rate of failures is pretty good evidence that the 1981 technique was no more successful than any of the techniques being used in early vaginoplasty, including those that are followed by dilation.

Why do you think that since your daughter's tubes are connected she must have surgery right away?  CAH does not affect a girl's internal reproductive anatomy.  Your daughter is no different from other girls who have CAH since their tubes are also connected.  That fact is no reason for an early vaginoplasty.  If those girls who had their vaginioplasties delayed until they were older had suffered from infections that fact would be well known by the authors of the August 2000 follow up and they would never have said that "vaginoplasty should be undertaken at the beginning of puberty."  There may be a medical justification for an immediate vaginoplasty on your daughter but having a normal set of internal reproductive organs is not it.  You really need to get a second opinion.

I would be glad to continue our discussion. Email me if you like.

Joan