Surgical treatment of vestibulovaginal hypospadias in girls
Soloviev A.E., Cherdantseva T.M., Zenushkin D.V.
Objective: To suggest a variant of surgical treatment of vestibulovaginal hypospadias in girls. Materials and methods: A total of 201 girls were diagnosed with vestibular hypospadias, 16 girls with vestibulovaginal hypospadias, and 3 girls with vaginal hypospadias. Five girls with vestibulovaginal hypospadias underwent surgery, namely, isolation of the urethra from the external orifice to the bladder neck and moving it below the clitoris. Results: The conservative treatment was prescribed to all children with hypospadias. It was effective only for the patients with the vestibular form of hypospadias. All children experienced vulvitis, vaginitis, chronic cystitis and pyelonephritis. Dystopia of the external urethral orifice was a manifestation of the vulvovaginal form of hypospadias. The X-ray examination revealed vesicoureteral reflux in six children and ureterohydronephrosis in two children. The girls with vestibulovaginal hypospadias (11 out of 16) continued to be treated conservatively. Five girls underwent surgical treatment with a good long-term result. Conclusion: Ineffective long-term therapy of vulvitis, vaginitis, cystitis, chronic pyelonephritis is an indication for surgical treatment of vestibulovaginal hypospadias. The lower wall of the urethra and the anterior wall of the vagina are a single formation in girls. Only the complete separation of the urethra from the vagina leads the operative manipulation to success. The presence of ectopia of the external urethral orifice, its permanent trauma during coitus may be a substrate of urinary tract infection in sexually mature women. Operative treatment serves as the prevention of postcoital complications in the future.
Authors' contributions: Soloviev A.E. – justification of the research concept (formulation of ideas, research goals and tasks), development of the research methodology; T.M. Cherdantseva – comparative analysis, generalization of study results; Zenushkin D.V. – collection, analysis and generalization of literature data.
Conflicts of interest: The authors declare no conflicts of interest.
Funding: The study was conducted without sponsorship.
Ethical Approval: The study was approved by the Ethical Review Board of the Ryazan State Medical University named after academician I.P. Pavlov, Ministry of Health of Russia.
Patient Consent for Publication: Girls’ mothers signed an informed consent for the publication of the data.
Authors' Data Sharing Statement: The data supporting the findings of this study are available on request from the corresponding author after approval from the principal investigator.
For citation: Soloviev A.E., Cherdantseva T.M., Zenushkin D.V. Surgical treatment of vestibulovaginal hypospadias in girls. Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2023; (10): 137-140 (in Russian) https://dx.doi.org/10.18565/aig.2023.144
Keywords
girls
vestibulovaginal hypospadias
surgical treatment
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Received 08.06.2023
Accepted 18.10.2023
About the Authors
Anatoly E. Soloviev, Dr. Med. Sci., Professor, Head of the Department of Pediatric Surgery, Ryazan State Medical University,Ministry of Health of Russia, beerzombie@rambler.ru, 390026, Russia, Ryazan, Vysokovoltnaya str., 9.
Tatiana M. Cherdantseva, Dr. Med. Sci., Professor, Head of the Department of Histology, Pathological Anatomy and Medical Genetics, Ryazan State Medical University, Ministry of Health of Russia, 390026, Russia, Ryazan, Vysokovoltnaya str., 9.
Denis V. Zenushkin, clinical resident at the Department of Pediatric Surgery, Ryazan State Medical University, Ministry of Health of Russia,
390026, Russia, Ryazan, Vysokovoltnaya str., 9.
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