Surgical Management of the Urogenital Sinus in Costa Rica National Children's Hospital.
DOI:
https://doi.org/10.54212/27068048.v7i1.49Keywords:
Urogenital sinus, National Children's Hospital (HNN), Passerini - GlazelAbstract
Introduction: The most common cause of urogenital sinus is congenital adrenal hyperplasia. In our country, only 7 cases managed by the urology service of the National Children's Hospital have been presented from 2015 to 2019, which is the only reference in the country. Before 2015, patients with this pathology were also approached by pediatric surgery in this center. There are multiple techniques to correct this malformation, those used in our hospital will be presented; the most novel being that of Passerini Glazel.
Methods: Observational, retrospective study through review of clinical records at the National Children's Hospital, Costa Rica.
Results: The highest incidence of cases was in the province of Alajuela. All patients had karyotype 46, XX. The diagnosis was in the neonatal stage. Virilization was very severe. The majority of patients resolved in a single surgical time. The complications were not severe. Three of the patients were operated with the Passerini - Glazel technique with excellent results, however patients operated with other techniques did not present severe discomfort or complications.
Conclusions: All the families in the study are currently very satisfied with the aesthetic results and the support provided by this hospital. The urogenital sinus is an infrequent pathology and should be treated with a comprehensive management clinic to the patient where support from endocrinology, urology, psychology and social work must be taken into account, which is currently in the process of being formed. The transition to adult hospitals is not adequate. There is a lot of difficulty in monitoring these patients; which should be strengthened. The observation of these patients should be continued to improve their quality of life.
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References
Peña A. Total urogenital mobilization: an easier way to repair cloacas. Comunicación presentada en julio de 1996 en: «3rd Meeting of the colorrectal club». Genova, Italia.
Peña A. Total urogenital mobilization: an easier way to repair cloacas. J Pediatric Surg 1997; 32:263-268.
https://doi.org/10.1016/S0022-3468(97)90191-3 DOI: https://doi.org/10.1016/S0022-3468(97)90191-3
Peña A. Surgical management of anorectal malformations: a unified concept. Pediatr Surg Int 1988; 3:82-93.
https://doi.org/10.1007/BF00182759 DOI: https://doi.org/10.1007/BF00182759
Hendren H. Surgical approach to intersex problems. Seminars Pediatr Surg 1998; 7:8-18.
https://doi.org/10.1016/S1055-8586(98)80003-6 DOI: https://doi.org/10.1016/S1055-8586(98)80003-6
Passerini G, Adams M, Rink R, Peña A, Hendren H. The high urogenital sinus. Dialogues in Pediatric Urology 1998; 21:1-8.
Peña A, Filmer B, Bonilla E, Méndez M, Stolar Ch. Transanorectal approach for the treatment of urogenital sinus: preliminary report. J Pediatr Surg 1992; 27:681-685. https://doi.org/10.1016/S0022-3468(05)80090-9 DOI: https://doi.org/10.1016/S0022-3468(05)80090-9
https://doi.org/10.1016/0022-3468(92)90956-8 DOI: https://doi.org/10.1016/0022-3468(92)90956-8
Peña A. The surgical management of persistent cloaca: results in 54 patients treated with a posterior sagital approach. J Pediatr Surg 1989; 24:590-598. https://doi.org/10.1016/S0022-3468(89)80514-7 DOI: https://doi.org/10.1016/S0022-3468(89)80514-7
Farkas, A., Chertin, B. y Hadas-Halpren, I. (2001) 1- stage feminizing genitoplasty: 8 years of experience with 49 cases. The Journal of Urology. 165. 2341-2346. https://doi.org/10.1016/S0022-5347(05)66199-X
https://doi.org/10.1097/00005392-200106001-00031 DOI: https://doi.org/10.1097/00005392-200106001-00031
García Medeiro, J.M., Martínez-Piñeiro, L.M., y de la Peña, J.J. (2002) Alteraciones del seno urogenital. ArchivosEspañoles de Urología.55(9). 1127- 1136.
Passerini- Glazel, G. (1989) A new 1- stage procedure for clitorovaginoplasty in severely masculinized female pseudohermaprodites. The Journal of Urology. 142. 565. https://doi.org/10.1016/S0022-5347(17)38817-1 DOI: https://doi.org/10.1016/S0022-5347(17)38817-1
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