Does common channel length affect surgical choice in female congenital adrenal hyperplasia patients?

• Published in: Journal of pediatric urology Vol. 10; no. 5; pp. 948 - 954
• Main Authors: Tugtepe, Halil, Thomas, David Terence, Turan, Serap, Cizmecioglu, Filiz, Hatun, Sukru, Bereket, Abdullah, Dagli, E. Tolga
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01.10.2014
• Subjects: Adrenal Hyperplasia, Congenital - pathology; Adrenal Hyperplasia, Congenital - surgery; Child, Preschool; Clitoris - surgery; Cloaca - pathology; Cloaca - surgery; Common channel; Congenital adrenal hyperplasia; Cystoscopy; Female; Humans; Infant; Pediatrics; Retrospective Studies; Suture Techniques; Urethra - surgery; Urogenital sinus mobilization; Urology; Vagina - surgery; Urogenital sinus mobilization; Common channel; Congenital adrenal hyperplasia
• ISSN: 1477-5131; 1873-4898
• DOI: 10.1016/j.jpurol.2014.02.012

Abstract Objective Partial/total urogenital sinus mobilization (UGSM) is one of the recommended techniques for treatment of female congenital adrenal hyperplasia (CAH). In this study we compared the length of common channel (CC) and type of operation performed in CAH patients. Patients and methods We retrospectively analyzed data of patients receiving surgery for female CAH. Patients were separated into three groups: group 1 had partial UGSM, group 2 had total UGSM, and group 3 had total UGSM plus the vaginal anterior wall was made from CC. Age at surgery, length of CC, surgical time, follow-up time, and complications were compared. Results There were a total of 29 patients. For groups 1, 2, and 3, the average age at surgery was 47.2 months, 14.4 months, and 21.3 months, respectively, and the average CC length was 1.25 cm, 3.1 cm, 4.3 cm, respectively. The average time of surgery was 165 min, 193.1 min, 282.5 min, respectively. The average follow-up time was 34.7 months, 36.3 months, 28.3 months, respectively. There were two complications (UGS flap necrosis and opening of sutures) in the third group. Conclusion We advise the use of partial UGSM for CC of 0.5–2 cm, total UGSM for CC of 2.5–3.5 cm, and total USM with use of CC as the anterior vaginal wall in CC ≥ 4 cm in length. Good cosmetic and functional results are obtained with this approach.