Document Type : Original research articles
Authors
1
General Surgery Department, Faculty of Medicine, South Valley University, Qena, Egypt
2
Pediatric Surgery, Faculty of Medicine, South Valley University, Qena, Egypt.
Abstract
Background: Disorders of sex development (DSD) include a diverse array of congenital disorders characterized by the abnormal growth of anatomical sex, chromosomes, gonads, & the brain, all of which are essential to the process of sexual differentiation.
Objectives: To evaluate the cosmetic outcome of feminizing genitoplasty in DSD.
Patients and methods: This interventional, non-controlled study was conducted on 50 virilizing females at Qena University Hospitals over one year. The study included detailed history, genital examination, Prader staging, serum electrolytes, karyotyping, hormonal profiles, abdominal ultrasound, genitography, cystoscopy, and surgeries (clitroplasty, vaginoplasty, labioplasty). Postoperative care involved antibiotics, analgesics, oral feeding, and vaginal calibration. Outcomes were assessed using Creighton and Lean scores.
Results: 38%of patients were under one year old; 92%had congenital adrenal hyperplasia, and 100% had 21-hydroxylase deficiency. Cosmetic outcomes were favorable, with 82% achieving good results. Postoperative complications were low: stress incontinence(8%), dysuria(6%), difficult micturition(4%), and wound infections(4%). Older age was significantly associated with poorer cosmetic outcomes(p=0.006) and increased stress incontinence(p=0.041), but not with dysuria, difficult micturition, or wound infections(p>0.05).
Conclusion: The number of patients with a decreased aldosterone level in the research cases was 41 (82%). The number of patients with an increased renin level in the research population was 41 (82%). The number of patients with a decreased cortisol level in the research population was 49 (98%). The number of patients with 17-OH-progesterone >20,000 ng/dl in the research population was 41 (82%). The number of patients with increased testosterone levels in the research cases was 50 (100%).
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