After doing much research on when the best time is to have the surgery on the labia, we have decided it is her best interest to wait until just before puberty. Some doctors advise using dialators for an indefinate amount of time. I could not fathom doing this to a 14 month old baby who has no need of her vagina right now. Below is just one of many articles stating that these surgeries often fail when done on infants. Then these childern need a second or even third surgery. Every time the skin is cut scar tissue forms and it doesn't stretch and can be painful. We decided that even though it will be very difficult for our preadolescent girl to have this surgery, we feel that it is in her best long term interest to wait. The clitoral surgery is her decision because having the surgery may possibly effect her for the rest of her life. One urologist stated that there could be a loss of sensation and there is no way of knowing if feeling is intact until she can tell us herself. This was just too scary for us. If she is uncomfortable with the way she looks and can fully comprehend the possible problems and loss of sensation, then we will support her in having the surgery. In my research, I realize that women come in many shapes and sizes. Even some girls with no hormonal problems have had clitorises that were deemed too large and were made to have this surgery. My own best friend watched me battle with this decision, saw my daughter nude after hot tubbing one day and told me she was so glad that we didn't have the surgery. Then she said that she, too, has a large clitoris and is glad that she was spared surgery. I had no idea but was thrilled with her trust in telling me something so personal. My daughter does not void through her clitoris and when standing you can't even see it. We don't have a problem with the size of it and hope that she doesn't either. J Urol 1999 May;161(5):1588-91 (ISSN: 0022-5347) Alizai NK; Thomas DF; Lilford RJ; Batchelor AG; Johnson N [Find other articles with these Authors] Department of Paediatric Urology, St. James's University Hospital and General Infirmary, Leeds, United Kingdom. PURPOSE: We document the postpubertal outcome of feminizing genitoplasty. MATERIALS AND METHODS: A total of 14 girls, mean age 13.1 years, with congenital adrenal hyperplasia were assessed under anesthesia by a pediatric urologist, plastic/reconstructive surgeon and gynecologist. Of these patients 13 had previously undergone feminizing genitoplasty in early childhood at 4 different specialist centers in the United Kingdom. RESULTS: The outcome of clitoral surgery was unsatisfactory (clitoral atrophy or prominent glans) in 6 girls, including 3 whose genitoplasty had been performed by 3 different specialist pediatric urologists. Additional vaginal surgery was necessary for normal comfortable intercourse in 13 patients. Fibrosis and scarring were most evident in those who had undergone aggressive attempts at vaginal reconstruction in infancy. CONCLUSIONS: These disappointing results, even in the hands of specialists, highlight the importance of late followup and challenge the prevailing assumption that total correction can be achieved with a single stage operation in infancy. Although simple exteriorization of a low vagina can reasonably be combined with cosmetic correction of virilized external genitalia in infancy, we now believe that in some cases it may be best to defer definitive reconstruction of the intermediate or high vagina until after puberty. The psychological issues surrounding sexuality in these patients are inadequately researched and poorly understood. Comment in: J UÑ@