Korean J Urol.  1996 Jul;37(7):815-819.

An Experience of Vaginoplasty with Bilateral Labioscrotal Flap (M-shaped flap) for Female Pseudohermaphroditism in Congenital Adrenal Hyperplasia

• Chung HY
• Seo KS
• Kim JS
• Rim JS

Abstract

The most common etiology for female pseudohermaphroditism is congenital adrenal hyperplasia, which accounts for more than 60 percent of children with ambiguous genitalia, and is treated with cortisol replacement and surgical correction of ambiguous genitalia. Flap vaginoplasty, the inverted U-Shaped type has been applied worldwide to the patient with low vaginal entry. The most frequent complication of the operation is contraction of the new vaginal introitus as a result of ischemic and fibrotic changes in the overlapping suture line between the flap and posterior vaginal wall. Maintenance of a good blood supply for the flap and tension free anastomosis should always be kept in mind to avoid this complication. We experienced a vaginoplasty with labioscrotal flap instead of the inverted U-shaped flap and achieved a good result in a 14-year-old girl with low vaginal entry due to congenital adrenal hyperplasia. The labioscrotal flap seems to be more suitable than inverted U-shaped flap for vaginoplasty because the labioscrotal skin is more elastic and more easily elongated than the perineal skin.

Keyword

ambiguous genitalia; flap vaginoplasty

MeSH Terms

46, XX Disorders of Sex Development*
Adolescent
Adrenal Hyperplasia, Congenital*
Child
Disorders of Sex Development
Female*
Humans
Hydrocortisone
Skin
Sutures
Hydrocortisone