Summary:
Feminizing genitoplasty (FGP) involves modification of a hypertrophic clitoris, vaginoplasty, and modelling
of the labia. FGP is performed during childhood and usually in one stage. In 1996–1999 30 patients with intersex
were operatedon. 25 girls with female pseudohermaphroditism caused by congenital adrenal hyperplasia (CAH),
3 patients with mixed gonadal dysgenesis (MGD), 1 patient with male pseudohermaphroditism and one female
patient with true hermaphroditism (HFV). Seventeen patients were between the ages of 3 and 6 years, 13 patients
(all female with CAH) were 13 to 21 years old. One-stage FGP, i.e. partial resection of the clitoris and vaginoplasty
(VP) was performed in 11 patients. A two-stage operation, i.e. partial resection of the clitoris and subsequent
vaginoplasty, was done in 3 patients (all with VHN with a high-orifice vagina). Vaginoplasty after excision of the
clitoris was made in 13 patients (all with CAH, 5 of them with a high-orifice vagina). Three female patients (2
VHN, 1 HFV) had partial resection of the clitoris and wait to have VP. Fourteen patients with partial resection
of the clitoris healed p.p. Healing p.s. was recorded in 5/27 patients with vaginoplasty (all CAH). Three of them
were older, menstruating and obese. In 4/14 patients after partial resection of the clitoris both modelling and
fixation of the glans clitoridis was necessary. Urinary incontinence was not recorded. Stricture of the vaginal
orifice was found in one 6-year-old patient with CAH after reconstruction of a high-orifice vagina. Thirteen older
patients have a normal vaginal orifice, two of them have sexual intercourse. FGP can be performed already at
toddler age, the cosmetic effect is favourable, the glans clitoridis is preserved and the psychosexual development
of patients is not impaired. FGP can be used also in adults, severely virilized patients.
Key words:
ambiguous genitalia – congenital adrenal hyperplasia – feminizing genitoplasty – clitoroplasty
– vaginoplasty
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