Genital Reconstructive Surgery in Females With Congenital Adrenal Hyperplasia: A Systematic Review and Meta-Analysis
| Autor: | Jehad Almasri, Shrikant Tamhane, Larry J. Prokop, Anoop Mohamed Iqbal, Feras Zaiem, Phyllis W. Speiser, Irina Bancos, M. Hassan Murad, Laurence S. Baskin, Rene Rodriguez-Gutierrez |
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| Rok vydání: | 2018 |
| Předmět: |
Reconstructive surgery
medicine.medical_specialty Pediatrics Sexual Behavior Endocrinology Diabetes and Metabolism Clinical Biochemistry 030232 urology & nephrology Urinary incontinence Clitoris Biochemistry 03 medical and health sciences Gynecologic Surgical Procedures 0302 clinical medicine Endocrinology Patient satisfaction Internal medicine medicine Humans Congenital adrenal hyperplasia Genital reconstructive surgery Adrenal Hyperplasia Congenital business.industry Genitourinary system Biochemistry (medical) Genitalia Female Plastic Surgery Procedures medicine.disease Treatment Outcome medicine.anatomical_structure Patient Satisfaction 030220 oncology & carcinogenesis Practice Guidelines as Topic Quality of Life Female medicine.symptom business Sexual function |
| Zdroj: | The Journal of Clinical Endocrinology & Metabolism. 103:4089-4096 |
| ISSN: | 1945-7197 0021-972X |
| DOI: | 10.1210/jc.2018-01863 |
| Popis: | Background Females with congenital adrenal hyperplasia (CAH) and atypical genitalia often undergo complex surgeries; however, their outcomes remain largely uncertain. Methods We searched several databases through 8 March 2016 for studies evaluating genital reconstructive surgery in females with CAH. Reviewers working independently and in duplicate selected and appraised the studies. Results We included 29 observational studies (1178 patients, mean age at surgery, 2.7 ± 4.7 years; mostly classic CAH). After an average follow-up of 10.3 years, most patients who had undergone surgery had a female gender identity (88.7%) and were heterosexual (76.2%). Females who underwent surgery reported a sexual function score of 25.13 using the Female Sexual Function Index (maximum score, 36). Many patients continued to complain of substantial impairment of sensitivity in the clitoris, vaginal penetration difficulties, and low intercourse frequency. Most patients were sexually active, although only 48% reported comfortable intercourse. Most patients (79.4%) and treating health care professionals (71.8%) were satisfied with the surgical outcomes. Vaginal stenosis was common (27%), and other surgical complications, such as fistulas, urinary incontinence, and urinary tract infections, were less common. Data on quality of life were sparse and inconclusive. Conclusion The long-term follow-up of females with CAH who had undergone urogenital reconstructive surgery shows variable sexual function. Most patients were sexually active and satisfied with the surgical outcomes; however, some patients still complained of impairment in sexual experience and satisfaction. The certainty in the available evidence is very low. |
| Databáze: | OpenAIRE |
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