Modern methodes of external genitalia correction in girls with congenital adrenal hypoplasia
Currently, the vast majority of clinics is common introitoplastika without separating the urinary and genital tract. In Izmailovskaya City Children's Hospital uses three methods of surgical correction of the external genitalia. The first group of patients (60 patients) performed surgical correction of defect by standard methods introitoplastiki M-shaped flap of skin with no separation of sexual and urinary tract, leading to a large number of complications in adult life in the form of recurrent urinary tract infections (94%), while the second group of patients (9 patients) was performed with division introitoplastika urinary and genital tract with preservation of the urogenital sinus fragments as orthotopic urethra. A third group of patients (5 patients) with mild forms of congenital adrenal hypoplasia, we conducted introitoplastiku in combination with plastic on the basis of the urethra Thiersch - Dyupleya. In the postoperative period, a girl in the second group was formed urethra-vaginal fistula, which closed on their own within a month. In the third group - received no complications. Thus, the presence of congenital external genitalia in girls with congenital adrenal hypoplasia, accompanied by a narrowing of the vestibule and hypospadias is an indication for introitoplastiki and creation of orthotopic urethra, with the aim of separation of sexual and urinary tract and prevent infections of the urinary and genital tract.