Zhang Zhengtao,Liu Guochang,Deng Fuming,et al.Preliminary exploration of pedicled prepuce island flap vaginoplasty for 46,XX DSD feminization[J].Journal of Clinical Pediatric Surgery,,():976-980.[doi:10.3760/cma.j.cn101785-202202023-014]
Preliminary exploration of pedicled prepuce island flap vaginoplasty for 46,XX DSD feminization
- Abstract:
- Objective To explore the application of pedicled prepuce island flap vaginoplasty for feminized children with masculinized 46, XX sexual dysplasia and high vaginal confluence and evaluate its efficacy. Methods From January 1, 2017 to December 1, 2020, 9 children with masculine 46, XX differences of sex development/disorders of sex development (46, XX DSD) underwent pedicled prepuce island flap vaginoplasty plus clitoris shortening and Y-V labioplasty.All of them belonged to salt loss type congenital adrenal hyperplasia (CAH) due to 21 hydroxylase deficiency.Prader type was Ⅲ-Ⅴ with high vaginal confluence.The average age was 20.2(10-62) month.Dressing was removed at Day 3-4 post-operation and discharge occurred at Day 5-7 post-operation.Urinary catheter and vaginal stent were removed at Week 2 post-operation. Results Among them, 8 cases were followed up for (12-60) month.The postoperative appearance of external genitalia was recognized by family members.One case of vaginal stenosis was improved through vaginal dilation.There were no onsets of such lower urinary tract symptoms as urinary incontinence, frequent urination and dysuria or urethrovaginal fistula.Both postoperative appearance and early function were satisfactory. Conclusions As an effective treatment for high vaginal confluence of masculine 46, XX DSD, vaginoplasty with pedicled prepuce island flap may be applied alone or in combination with total urogenital mobilization (TUM).After operation, a narrow vagina forms with an opening in vestibule, decent urinary control and satisfactory appearance of external genitalia.It is suitable for all kinds of vulva feminization surgery.
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Memo
收稿日期:2022-2-9。
基金项目:国家自然科学基金青年项目(82200742)
通讯作者:伏雯,Email:18883330@qq.com