I don't think this one has been posted before.

 

Horm Res 2004;62(suppl 2):1-215

P1-121 Paediatric Gynaecology

 

Stenosis in Girls with Congenital Adrenal

Hyperplasia who have Early Vaginal Surgery

V Puthi1, M Didi1, A Garden2

1Royal Liverpool Children’s Hospital, Endocrinology, Liverpool, United

Kingdom; 2Royal Liverpool Children’s Hospital, Gynaecology, Liverpool,

United Kingdom

Contact e-mail: vijith89@yahoo.co.uk

 

There is controversy about the need for surgery if at all and best time for surgery

in girls who have been virilised in-utero due to Congenital Adrenal Hyperplasia

(CAH). We have therefore analysed the outcome in girls who had surgery in our

centre. To study the outcome of patients with CAH who underwent feminising surgery

a 30 yr retrospective study of surgery carried out by one of three surgeons.

Age and type of early surgery, time between surgery and first assessment, age and

type of further intervention/s and duration of follow up were ascertained. Twenty

patients were studied. 19 of these patients had early surgery at a median age of

11.5 months (range 4 months-6 years). 9/19 patients (48%) had only clitoral surgery

at a median age of 11months (4-26months). 5 of these 9 patients have so far

required further intervention. Median age 9.4 years (2.4-18 years). Four of them

had vaginoplasty at a median age of 11.5 years and one of them had excision of

redundant labial skin. 2 of the 4 patients who had vaginoplasty subsequently

developed vaginal stenosis at the age 21yrs and 11years. 10 patients had early clitoral

and vaginal surgery at a median age of 13.5 months (4-72 months). Eight out

of these 10 patients need further surgery (3 had only vaginoplasty, 1 is scheduled

for vaginoplasty and 3 had clitoral and vaginoplasty and 1 had excision of skin

tags). 6 of these 10 patients who had early clitoral and vaginal surgery developed

vaginal stenosis at a median age of 14.7 years. Two patients in this group also had

urinary incontinence. The incidence of vaginal stenosis in early vaginal surgery

(6/10) was significantly higher than in those with only early clitoral surgery (2/9)

(î2, p: < 0.05).

 

Conclusion: Patients with early vaginal surgery CAH have a higher

incidence of further vaginal surgery and vaginal stenosis compared with patients

who had only early clitoral surgery.

 

P1-122 Paediatric Gynaecology