Virilized external genitalia in young girls: clinical characteristics and management challenges in a low-resource setting
| Autor: | C. O. Adiri, I.O. Igwilo, Sebastian O. Ekenze, O.O. Onumaegbu |
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| Rok vydání: | 2013 |
| Předmět: |
Pediatrics
medicine.medical_specialty Health Knowledge Attitudes Practice Delayed Diagnosis Referral Developing country Nigeria Clitoris Health Services Accessibility Vulva Gynecologic Surgical Procedures Interquartile range Health care medicine Humans Developing Countries Health Education Retrospective Studies business.industry Virilization Obstetrics and Gynecology Infant Surgical wound General Medicine Genitalia Female Plastic Surgery Procedures Virilism Child Preschool Pediatrics Perinatology and Child Health Vagina Health education Female medicine.symptom Presentation (obstetrics) business |
| Zdroj: | Journal of pediatric and adolescent gynecology. 27(1) |
| ISSN: | 1873-4332 |
| Popis: | Objective Virilization of the external genitalia in young girls (VEG) manifests mostly as ambiguity of the genitalia and elicits concerns and uncertainties especially in settings with poor awareness. This study evaluates the profile and challenges of VEG in southeast Nigeria. Methods We analyzed 23 children with VEG managed in 2 referral centers in southeast Nigeria from June 2005 to January 2013. Results They presented at median age of 13.3 months (interquartile range [IQR] 3 months-3 years). The cases included 3 (13%) of Prader type 1, 6 (26%) of type 2, 11 (48%) of type 3, and 3 (13%) of type 4. Five of the Prader type 3 and all 3 cases of Prader type 4 were reared as male prior to presentation. Following evaluation, all the cases were assigned female gender at a mean age of 2.7 years (range 2 months-10.5 years). Appropriate feminizing genitoplasty was undertaken in all the cases and after a follow-up period of 3 months to 5 years (mean 2 years), 2 patients developed vaginal stenosis, and 3 cases had surgical wound infection. Poor awareness, delayed presentation, inadequate facilities, and lack of trained manpower were the challenges in the management of the cases. Conclusion VEG in our setting is associated with delayed management. Focused health education and public awareness programs, and improved healthcare funding may improve outcome and minimize the need for gender reassignment. |
| Databáze: | OpenAIRE |
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