FEMINIZING GENITOPLASTY IN CLASSIC CONGENITAL ADRENAL HYPERPLASIA- EXPERIENCE AT KHYBER TEACHING HOSPITAL, PESHAWAR
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Abstract
Objective: To evaluate the outcomes of single stage feminizing genitoplasty in patients with congenital adrenal hyperplasia(CAH) in terms of surgical complications ,parents’ satisfaction and their determinants. Setting Khyber teaching hospital Peshawar. Methodology: In this retrospective case series 32 patients who underwent single stage genitoplasty between January 2015 to January 2019 were included .Patients with common channel longer than 2.5 cm and those operated elsewhere were excluded. Parents were interviewed retrospectively and data was collected. Ethical approval was granted by IREB. Outcome was called ‘’successful’’ in patients with no complication at follow up.Parents and surgeons satisfaction with cosmesis was recorded from evaluated pre and post op photoraphs and separately labelled as “satisfied” or “not satisfied”. Data was analysed by using SPSS version 22. Results: Mean age of the patients at surgery was 9.71 ± 1.72 months (6-18 months).21(65.25%) patients were in age group 6 to 12 months while 11(34.37%) were in age group 13 to 18 months.The mean operative time was 180.22+22.41 minutes.No flap ischemia(0.0%) ,vesicovagnia/veginorectal(0.0%), or surgical site infection(0.0%) was observed in any patient . Urinary incontinence was seen in 1 (3.12%) patient, while urinary tract infections were observed in 3 (9.37%) patients.Two patients (6.25%) had vaginal stenosis at follow up calibration. Parents were satisfied with cosmetic outcome in 30 (93.8%) cases and surgeon in 29 (90.62%) patients. Success rate was found higher i.e. 90.47% and 100.0% in younger age groups and lower CAH grades (P<0.05), respectively. Conclusion: The early follow up of females with CAH receiving single stage feminizing genitoplasty have shown promising results in terms of low complication rates and high satisfaction rates of parents.
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