An Experience of Vaginoplasty with Bilateral Labioscrotal Flap (M-shaped flap) for Female Pseudohermaphroditism in Congenital Adrenal Hyperplasia.
- Author:
Hun Young CHUNG
1
;
Kie Seok SEO
;
Jong Sung KIM
;
Joung Sik RIM
Author Information
1. Department of Urology, Workwang University School of medicine, Iksan, Korea.
- Publication Type:Case Report
- Keywords:
ambiguous genitalia;
flap vaginoplasty
- MeSH:
46, XX Disorders of Sex Development*;
Adolescent;
Adrenal Hyperplasia, Congenital*;
Child;
Disorders of Sex Development;
Female*;
Humans;
Hydrocortisone;
Skin;
Sutures
- From:Korean Journal of Urology
1996;37(7):815-819
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
The most common etiology for female pseudohermaphroditism is congenital adrenal hyperplasia, which accounts for more than 60 percent of children with ambiguous genitalia, and is treated with cortisol replacement and surgical correction of ambiguous genitalia. Flap vaginoplasty, the inverted U-Shaped type has been applied worldwide to the patient with low vaginal entry. The most frequent complication of the operation is contraction of the new vaginal introitus as a result of ischemic and fibrotic changes in the overlapping suture line between the flap and posterior vaginal wall. Maintenance of a good blood supply for the flap and tension free anastomosis should always be kept in mind to avoid this complication. We experienced a vaginoplasty with labioscrotal flap instead of the inverted U-shaped flap and achieved a good result in a 14-year-old girl with low vaginal entry due to congenital adrenal hyperplasia. The labioscrotal flap seems to be more suitable than inverted U-shaped flap for vaginoplasty because the labioscrotal skin is more elastic and more easily elongated than the perineal skin.
