Use of Vaginoscopy after Vaginoplasty in Individuals with Congenital Adrenal Hyperplasia.
Autor: | Kamceva M; Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts., Strickland J; Division of Gynecology, Department of Surgery, Children's Mercy Hospital, Kansas City, Missouri; Department of Obstetrics and Gynecology, University of Missouri Kansas City, Kansas City, Missouri., Gatti J; Department of Urology, Children's Mercy Hospital, Kansas City, Missouri; Department of Urology, University of Missouri Kansas City, Kansas City, Missouri., Grimstad FW; Division of Gynecology, Department of Surgery, Children's Mercy Hospital, Kansas City, Missouri; Department of Obstetrics and Gynecology, University of Missouri Kansas City, Kansas City, Missouri; Division of Gynecology, Department of Surgery, Boston Children's Hospital, Boston, Massachusetts; Department of Obstetrics, Gynecology, and Reproductive Biology, Harvard Medical School, Boston, Massachusetts. Electronic address: Frances.grimstad@childrens.harvard.edu. |
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Jazyk: | angličtina |
Zdroj: | Journal of pediatric and adolescent gynecology [J Pediatr Adolesc Gynecol] 2024 Dec; Vol. 37 (6), pp. 602-607. Date of Electronic Publication: 2024 Aug 24. |
DOI: | 10.1016/j.jpag.2024.08.008 |
Abstrakt: | Study Objective: To explore the use of exam under anesthesia with vaginoscopy (EUA-V) after vaginoplasty in patients with congenital adrenal hyperplasia (CAH) DESIGN: Retrospective cohort METHODS: An institutional review board-approved retrospective chart review was performed of the postsurgical follow-up care of all patients diagnosed with classic CAH who sought care at a tertiary children's hospital from 2000 to 2017 and had undergone vaginoplasty at that institution. Results: Twenty-six patients met the inclusion criteria. The median age at vaginoplasty was 1.25 years (IQR 0.67-9). The median postsurgical follow-up was 5.5 years (IQR 1.5-9). Twenty-six EUA-Vs were performed, on 22 patients. Four were for complication assessment (rectovaginal fistula 1 and urethrovaginal fistula 3 -on the same patient). The remaining 22 EUA-Vs, performed on 20 patients with 2 each undergoing 2 EUA-Vs, were planned for routine evaluation of vaginal patency. They were done a median of 0.67 years (IQR 0.25-2) after surgery and at a median of 6.67 years of age (IQR 1.75-12). Of these, 5 EUA-Vs identified stenosis in 5 patients (25%), a median of 0.91 years (IQR 0.5-7) after surgery, at a median age of 8.42 years (IQR 2-10.92). Of the 4 who did not undergo EUA-V, 1 had stenosis on clinical exam with ultrasound-verified hematocolpos. The remaining 3 were all prepubertal at last follow-up. Conclusion: Most CAH patients after vaginoplasty underwent routine EUA-V, roughly a quarter of which detected stenosis. EUA-Vs may play a beneficial role in routine postoperative care after vaginoplasty in patients with CAH. Competing Interests: Declaration of competing interest The authors report no conflicts of interest. (Copyright © 2024. Published by Elsevier Inc.) |
Databáze: | MEDLINE |
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