Document Type : Original research

Authors

• Ali Sharaf muhammed ¹
• Hasan Kareem Gatea ²

¹ Pediatric surgeon, delivary and gynecology and pediatrics hospital,kirkuk,iraq

² Department of Pediatric Surgery/Baghdad University/Collage of Medicine/Baghdad/Iraq

Abstract

Background: Differences of sexual development (DSD) is a congenital condition in which the development of the infant/child’s chromosomal, gonadal, and anatomic sex are atypical. The aim of the study is to evaluate early results and complications of feminizing genitoplasty and to establish proper database for future research.
Methods: A prospective descriptive study focused on 24 patients who underwent feminizing genitoplasty by the same pediatric surgery team. Operations included cutback vaginoplasty, partial urogenital mobilization, Fortunoff flap, or staged feminizing genitoplasty. Postoperatively, patients received IV analgesia and antibiotics throughout their hospital stay. Wound care began on the second day after surgery, involving normal saline and moist exposed burn ointment (MEBO).
Result: The study included 24 patients aged 1 to 13 years (mean age: 6 years). Birth-assigned gender was 62.5% female and 37.5% male. Diagnoses comprised 95.83% CAH and 4.16% Partial Androgen Insensitivity Syndrome. Chromosomal analysis revealed 95.83% XX and 4.16% XY. Prader’s classification indicated 74.07% as Prader3/4. Urogenital sinus length was ≤3cm in 83.33%, >3cm in 16.66%. Surgical approaches: 70.83% underwent partial urogenital mobilization with clitoroplasty, monsplasty, labioplasty, Fortunoff flap; 16.66% cutback vaginoplasty; 12.5% staged repair without vaginal replacement. Post-op, 8.33% experienced minor bleeding, 4.14% seroma, 16.66% wound infection, 4.16% minor labia majora wound dehiscence: no clitoral loss, urinary issues. Patient/family satisfaction: 87.5% reported good, 12.5% satisfactory outcomes.
Conclusions: Feminizing genitoplasty is a safe surgery with relatively low complication rates and good cosmetic outcome when performed by surgeons with experience in this field.

Keywords

• Sex development disorders
• congenital adrenal hyperplesia
• feminizing genitoplasty
• urogenital sinus mobilization
• Fortunoff flap

Main Subjects

• Pediatrics