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Vaginoplasty and creating labia minora in children with disorders of sex development

  • Urology - Original Paper
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Abstract

Purpose

To report current results of vaginoplasty using the mucosa of the prepuce, and creating labia minora by penile skin in children with disorders of sex development (DSD).

Methods

In 10 years, we have performed 22 vaginoplasties using the described technique of vaginoplasty, 21 patients with 46, XX DSD and 1 ovotesticular DSD. The assessment of the results of this technique of vaginoplasty was undertaken in several stages: (a) The evaluation of the cosmetic result. (b) The research for a urinary incontinence and urethrovaginal fistulas. (c) The research for a vaginal stenosis by the introduction of a lubricated feeding tube into the vaginal cavity.

The labia minora was evaluated by three criteria: its skin should be thin and very supple, it should have a free edge which partially or totally covers the clitoris, urethral meatus, and vaginal orifice; and it is preferable that its color be darker than the rest of the skin.

Results

The cosmetic outcome was considered by parents and the surgeon as very satisfactory in 11 patients (50% of cases), satisfactory in 4 patients (18.2%), and unsatisfactory in 7 patients (31.8%). The postoperative complications were five cases of proximal stenosis (22.7%), one distal stenosis (stenosis of introitus) and two necrosis of the preputial flap. No urethrovaginal fistula and urinary incontinence were reported.

Conclusions

In infant and young child, when it is difficult to make use of complete urogenital mobilization, the mucosa of the prepuce can be an alternative to create a neovagina, its histological constitution is identical to a vaginal wall, and it does not prevent to have a good labia minora.

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Author information

Authors and Affiliations

  1. Department of Visceral Surgery, Faculty of Medicine, Children’s Hospital Canastel, University of Oran, Oran, Algeria

    Smail Acimi, Naima Abderrahmane & Lamia Debbous

  2. Department of Gastroenterology and Endocrinology, Faculty of Medicine, Children’s Hospital Canastel, University of Oran, Oran, Algeria

    Mimouna Bessahraoui

  3. Department of Surgery, Faculty of Medicine, EHU of Oran, University of Oran, Oran, Algeria

    Mohammed Ali Acimi

Authors
  1. Smail Acimi
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  2. Mimouna Bessahraoui
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  3. Mohammed Ali Acimi
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  4. Naima Abderrahmane
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  5. Lamia Debbous
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Corresponding author

Correspondence to Smail Acimi.

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Conflict of interest

All authors declare that they have no conflict of interest.

Ethical approval

This study conforms to the World Medical Association Declaration of Helsinki (June 1964) and subsequent amendments and the investigations were carried out to a high ethical standard. However, in our country, there is not a formal and documented ethical approval from an appropriately constituted Research Ethics Committee, which should be obtained for all studies involving human.

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Acimi, S., Bessahraoui, M., Acimi, M.A. et al. Vaginoplasty and creating labia minora in children with disorders of sex development. Int Urol Nephrol 51, 395–399 (2019). https://doi.org/10.1007/s11255-018-2058-8

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  • DOI: https://doi.org/10.1007/s11255-018-2058-8

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