A feminization plastic surgical procedure for a high urethrovaginal confluence and a long genitourinary common channel in puberty girls with a disorder of sexual development
Objective: To improve the results of feminization plastic surgeries in girls with a disorder of sexual development.Anikiev A.V., Brovin D.N., Volodko E.A., Okulov A.B., Andreeva E.N.
Materials and methods: A procedure was proposed for dissociative feminization plastic surgery, which was used in 2018 to 2019 to operate on four girls in the chronological and clinico-hormonal therapy-induced puberty period with virilization of the external genitalia, a high urethrovaginal confluence (UVC), and a long genitourinary common channel (GUCC).
Results: Based on the partial urogenital mobilization described by R.C. Rink in 2006, the authors developed a new procedure of feminization plastic surgery for puberty patients with a high UVC and a long GUCC. The procedure is characterized by the preparation of a mucosal flap of the GUCC, by laying it in a W-shaped way to create the anterior and lateral walls of the artificial vaginal orifice (AVO) and preparing the posterior wall of the vagina to create the posterior wall of the AVO. The calculation of the minimum GUCC length, which is required for successful surgery, is presented. Good results were obtained in all the patients.
Conclusion: The proposed procedure makes it possible to form the female external genitalia with the separately opening urethra and vagina, with the moist mucous orifice, with the possibility of adequate sexual life in the future, without the risk of vaginal stenosis and urinary disorders.
Keywords
high urethrovaginal confluence
urogenital mobilization
disorder of sexual development
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Received 15.02.2021
Accepted 01.06.2021
About the Authors
anikieal70@gmail.com, https://orcid.org/0000-0002-6448-6842, 117036, Russia, Moscow, Dm. Ulyanova str., 11.Dmitriy N. Brovin, PhD, Head of Pediatric Surgeon Department, National Medical Research Center of Endocrinology, Ministry of Health of Russia, brovin-dn@yandex.ru, https://orcid.org/0000-0002-3734-6510, 117036, Russia, Moscow, Dm. Ulyanova str., 11.
Elena A. Volodko, Dr. Med. Sci., Professor of Pediatric Surgery Department, Russian Medical Academy of Continuous Professional Education, Ministry of Health of Russia,
okulov20@yandex.ru, https://orcid.org/0000-0002-4667-214X, 125993, Russia, Moscow, Barrikadnaya str., 2/1 b.1.
Alexey B. Okulov, Dr. Med. Sci., Professor of Pediatric Surgery Department, Russian Medical Academy of Continuous Professional Education, Ministry of Health of Russia,
okulov20@yandex.ru, https://orcid.org/0000-0002-8921-2856, 125993, Russia, Moscow, Barrikadnaya str., 2/1 b.1.
Elena N. Andreeva, Dr. Med. Sci., Professor, Director of Reproductive Medicine Institution, Head of Endocrine Gynecology Department, Professor of Department
of Endocrinology, National Medical Research Center of Endocrinology, Ministry of Health of Russia, endogin@mail.ru, https://orcid.org/0000-0002-5949-1815,
117036, Russia, Moscow, Dm. Ulyanova str., 11.
Corresponding author: Alexander V. Anikiev, anikieal70@gmail.com
Authors’ contributions: Andreeva E.N., Okulov A.B. – concept and design of the investigation; Anikiev A.V., Brovin D.N. – material collection and processing; Anikiev A.V., Volodko E.A. – writing the text; Andreeva E.N., Volodko E.A. – editing.
Conflicts of interest: The authors declare that there are no conflicts of interest.
Funding: No funding for this investigation has been provided by any organizations.
Patient Consent for Publication. Mothers of patients provided informed consent for the publication of data and associated images.
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 сitation: Anikiev A.V., Brovin D.N., Volodko E.A., Okulov A.B., Andreeva E.N. A feminization plastic surgical procedure for a high urethrovaginal confluence and a long genitourinary common channel in puberty girls with a disorder of sexual development.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2021; 9: 156-162 (in Russian)
https://dx.doi.org/10.18565/aig.2021.9.156-162
