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SURGICAL CORRECTION OF THE HIGH UROGENITAL SINUS IN GIRLS WITH CONGENITAL ADRENAL HYPERPLASIA USING THE ANTERIOR SAGITTAL TRANSANORECTAL APPROACH
- Authors: Kagantsov I.M.1,2, Shiryaev N.D.3, de Castro R.4
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Affiliations:
- Republican Children’s Clinical Hospital
- Syktyvkar State University named after Pitirim Sorokin
- North State Medical University of the Ministry of Health of Russia
- Hospital CdC Petrucciani
- Issue: Vol 8, No 1 (2018)
- Pages: 13-22
- Section: Original Study Articles
- URL: https://rps-journal.ru/jour/article/view/394
- DOI: https://doi.org/10.17816/psaic394
- ID: 394
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Abstract
Surgical correction of the high urogenital sinus (UGS) is still a complex task. The use of complete urogenital mobilization or mobilization using a single block in the high UGS is inconsistent. We prefer to separate the vagina from the UGS with its subsequent bringing down to the perineum. The anterior sagittal transrectal approach ensures an optimal review of the uretrovaginal fusion and promotes the vaginal displacement and its separation from the urethra in these cases. The method generates an increasing interest. Thus, we describe the procedure and announce the initial results of its usage in the treatment of children with the high UGS.
About the authors
I. M. Kagantsov
Republican Children’s Clinical Hospital;Syktyvkar State University named after Pitirim Sorokin
Author for correspondence.
Email: ilkagan@rambler.ru
Dr.Sci (med), Department of Surgical Diseases, Pitirim Sorokin SSU,
Syktyvkar
Russian FederationN. D. Shiryaev
North State Medical University of the Ministry of Health of Russia
Email: nikshir@yandex.ru
Dr.Sci (med),
Arkhangelsk
Russian FederationRoberto de Castro
Hospital CdC Petrucciani
Email: decastro1610@gmail.com
Prof.,
Lecce
ItalyReferences
- Hendren W. H., Crawford J. D. Adrenogenital syndrome: The anatomy of the anomaly and its repair. J. Pediatr. Surg., 1969, 4, 49–58.
- Domini R., Rossi F., Ceccarelli P. L., De Castro R. Anterior sagittal transanorectal approach to the urogenital sinus in adrenogenital syndrome: preliminary report. J. Pediatr. Surg., 1997, 32, 5, 714–716.
- Pippi Salle L., Lorenzo A. J., Jesus L. E. et al. Surgical treatment of high urogenital sinuses using the anterior sagittal transrectal approach: A useful strategy to optimize exposure and outcomes. J. Urol., 2012, 187, 1024–1031.
- Rink R. C., Adams M. C. Feminizing genitoplasty: State of the art. World J. Urol., 1998, 16, 212–218.
- Rink R. C., Adams M. C., Misseri R. A new classification for genital ambiguity and urogenital sinus anomalies. BJU Int., 2005, 95, 638–642.
- Rink R. C., Metcalfe P. D., Cain M. P. Use of the mobilized sinus with total urogenital mobilization. J. Urol., 2006, 176, 2205–2211.
- Tugtepe H., Thomas D. T., Turan S. Does common channel length affect surgical choice in female congenital adrenal hyperplasia patients? J. Pediatr. Urol., 2014, 10, 948–954.
- Gozalbez R., Castellan M., Ibrahim E. New concepts in feminizing genitoplasty – is the Fortunoff flap obsolete? J. Urol., 2005, 174, 2350–2353.
- Gonzalez R., Ludwikiwski B. Management of the high urogenital sinus – Risk of overexposure? J Urol., 2012, 187, 787–788.
- Pena A., Filmer B., Bonilla E. et al. Transanorectal approach for the treatment of urogenital sinus: preliminary report. J. Pediatr. Surg., 1992, 27, 681–685.
- Rink R. C., Pope J. C., Kropp B. P. et al. Reconstruction of the high urogenital sinus: early perineal prone approach without division of the rectum. J. Urol., 1997, 158, 1293–1297.
- Ширяев Н. Д., Каганцов И. М. Очерки реконструктивной хирургии наружных половых органов у детей. Ч. 2. Сыктывкар, 2012, с. 81. [Shiryaev N. D., Kaganov I. M. Essays on reconstructive surgery of the external genitalia in children. Part 2. Syktyvkar, 2012, р. 81. (In Russian)]
- Creighton S. M., Chernausek S. D., Romao R., Ransley P. G., Pippi Salle J. Timing and nature of reconstructive surgery for Disorders of Sex Development – Introduction. J. Pediatr. Urol., 2012, 8, 602–610.
- Rossi F., De Castro R., Ceccarelli P. L., Domini R. Anterior sagittal transanorectal approach to the posterior urethra in the pediatric age group. J Urol., 1998, 160, 1173–1177.
- Arena F., Romeo C., Cruccetti A. et al. The neonatal management and surgical correction of urinary hydrometrocolpos caused by a persistent urogenital sinus. BJU Int., 1999, 84, 1063–8.
- Mauermann J., González R., Franc-Guimond J., Filipas D. The anterior sagittal transrectal approach for traumatic urethrovaginal fistula closure. J Urol., 2004, 171, 1650–1651.
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